Dewaguet Julie, Beaujot Juliette, Leguillette Clémence, Decanter Gauthier, Cordoba Abel, Penel Nicolas, Ceugnart Luc, Taieb Sophie, Amor Mariem Ben Haj
Centre Oscar-Lambret, département d'imagerie, 3, rue Combemale, 59020 Lille cedex, France.
Centre Oscar-Lambret, département d'anatomie et cytologie pathologique, 3, rue Combemale, 59020 Lille cedex, France.
Bull Cancer. 2023 Oct;110(10):1015-1026. doi: 10.1016/j.bulcan.2023.05.009. Epub 2023 Jul 26.
Myxoid liposarcoma is a soft tissue sarcoma associated with multifocal metastases at diagnosis. These metastases are asymptomatic and occult on CT and FDG-PET and can alter the therapeutic management and prognosis. In this context, we evaluated the contribution of whole-body MRI to the initial workup of patients with myxoid liposarcoma.
This retrospective study was conducted between January 2015 and December 2020 at the Oscar Lambret Center. We enrolled 22 patients who were diagnosed with myxoid liposarcoma and underwent whole-body MRI at diagnosis. The number of metastases at diagnosis, their location, and the visibility of these lesions on CT were evaluated. Associations between clinical features, presence of metastasis, and their impact on management were assessed.
Sixteen patients (72.7%) had non-metastatic disease at the initial diagnosis, and 15 of these patients were managed using local treatment. Six patients (27.3%) had metastases at multiple locations and received chemotherapy. The main locations were the bones (n=5) and lungs (n=3). In five patients with metastases, whole-body MRI demonstrated additional lesions that were not visible on CT (bone and soft tissue lesions). Only the presence of a round cell contingent (P=0.009) was found as a criterion associated with the presence of metastases.
The patients' young age, absence of reliable prognostic factors at diagnosis, asymptomatic nature of the lesions, and the benefits of early and targeted therapeutic management encourage the use of whole-body MRI as part of the initial work-up as it seems to provide a better initial staging compared with conventional imaging.
黏液样脂肪肉瘤是一种软组织肉瘤，在诊断时易发生多灶转移。这些转移灶无症状，在CT和FDG-PET上隐匿，可改变治疗管理和预后。在此背景下，我们评估了全身MRI在黏液样脂肪肉瘤患者初始检查中的作用。
这项回顾性研究于2015年1月至2020年12月在奥斯卡·兰布雷特中心进行。我们纳入了22例被诊断为黏液样脂肪肉瘤并在诊断时接受全身MRI检查的患者。评估了诊断时转移灶的数量、位置以及这些病变在CT上的可见性。评估了临床特征、转移灶的存在及其对治疗管理的影响之间的关联。
16例患者（72.7%）在初始诊断时无转移，其中15例患者接受了局部治疗。6例患者（27.3%）有多处转移并接受了化疗。主要部位是骨骼（n=5）和肺部（n=3）。在5例有转移的患者中，全身MRI显示了CT上不可见的额外病变（骨骼和软组织病变）。仅发现圆形细胞成分的存在（P=0.009）是与转移存在相关的标准。
患者年龄较轻、诊断时缺乏可靠的预后因素、病变无症状以及早期和靶向治疗管理的益处，促使将全身MRI作为初始检查的一部分使用，因为与传统成像相比，它似乎能提供更好的初始分期。
