MRI features of Stewart-Treves syndrome: a case series and systematic review.

PURPOSE

To comprehensively summarize the magnetic resonance imaging (MRI) features of angiosarcomas presenting as Stewart-Treves syndrome (STS) through a retrospective case series and systematic review of previous publications.

MATERIALS AND METHODS

We identified five patients with STS from our institutional database and 25 patients with STS from 15 publications through a systemic review. We reviewed the MR features of 30 patients with STS, including five males and 25 females with a mean age of 59.5 years.

RESULTS

The tumors most commonly involved both the cutis and subcutis (17/25, 68.0%); the remaining tumors were limited to the cutis or subcutis. Multiple tumors were observed in more than half of the cases (16/27, 59.3%), and most of the tumors had poorly defined margins (26/28, 92.9%). The most common signal intensities of the tumors on T1-weighted images were intermediate (16/19, 84.2%), and the remainder were a mixture of intermediate and high, with a predominance of intermediate signal intensity. The signal intensities of the tumors on T2-weighted images were intermediate in seven cases (7/13, 53.8%), a mixture of intermediate and high in five cases (5/13, 38.5%), and a mixture of intermediate and low in one case (1/13, 7.7%). Available diffusion-weighted images from four institutional cases showed restricted diffusion of the tumors with mean apparent diffusion coefficient (ADC) values ranging from 0.77 × 10 mm/s to 0.96 × 10 mm/s.

CONCLUSION

Typical MRI features of angiosarcomas in STS were superficially located in multiple masses with ill-defined margins. Internal signal intensity was intermediate on T1-weighted images, and intermediate or a mixture of intermediate and high on T2-weighted images. ADC values obtained from the limited number of cases were low.