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MRI and CT of Low-Grade Fibromyxoid Sarcoma in Children: A Report From Children's Oncology Group Study ARST0332
Journal article   Open access   Peer reviewed

MRI and CT of Low-Grade Fibromyxoid Sarcoma in Children: A Report From Children's Oncology Group Study ARST0332

Kiran Sargar, Simon C Kao, Sheri L Spunt, Douglas S Hawkins, David M Parham, Cheryl Coffin and M Beth McCarville
American journal of roentgenology (1976), Vol.205(2), pp.414-420
08/2015
DOI: 10.2214/AJR.14.13972
PMCID: PMC4570741
PMID: 26204295
url
https://doi.org/10.2214/AJR.14.13972View
Published (Version of record) Open Access

Abstract

The purpose of this article is to determine the MRI and CT features of low-grade fibromyxoid sarcoma in children. We retrospectively analyzed images of 11 pediatric patients with low-grade fibromyxoid sarcoma from a phase 3 clinical trial of nonrhabdomyosarcoma soft-tissue sarcoma (Children's Oncology Group Protocol ARST0332). MRI and CT were performed in 10 and four patients, respectively. Location, size, margin, and composition on imaging were correlated with pathologic findings. Tumors were located in the extremities in nine patients, and one tumor each was located in the tongue and lung. Tumors were deep in seven patients and superficial in four patients. All tumors were well defined, solitary, and nonmetastatic at presentation. Tumors were complex solid-cystic in eight patients and completely solid in three patients. On T1-weighted images, all tumors had at least some areas hypointense to muscles, and six had a split-fat sign. On STIR or T2-weighted images, eight tumors had areas hypointense to adjacent muscle, and eight tumors had fluid signal intensity. On contrast-enhanced MRI studies, eight tumors had thick enhancing internal septations, and three had peripheral nodular gyriform enhancement. When we correlated imaging to pathologic findings, areas with hypointense signal intensity on both T1- and T2-weighted images were likely related to fibrous component; areas with fluid signal intensity on T2-weighted images were likely related to myxoid component. On CT, all four tumors were hypodense to muscle, and one tumor showed punctate calcific foci. Low-grade fibromyxoid sarcoma is hypodense to muscle on CT. MRI may identify both fibrous and myxoid components of this rare pediatric soft-tissue sarcoma.
Fibroma - diagnosis Humans Child, Preschool Magnetic Resonance Imaging - methods Tomography, X-Ray Computed - methods Male Sarcoma - pathology Fibroma - pathology Contrast Media Neoplasm Grading Sarcoma - surgery Adolescent Female Retrospective Studies Sarcoma - diagnosis Fibroma - surgery Child

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