Yara Younan1, Anthony Martinez2, Nickolas Reimer3, Mark Edgar2, Felix Gonzalez1, Monica Umpierrez1, Ty Subhawong4, Adam D Singer5. 1. Department of Radiology and Imaging Sciences Section of Musculoskeletal Imaging, Emory University Hospital, 59 Executive Park South, 4th Floor Suite 4009, Atlanta, GA, 30329, USA. 2. Department of Pathology, Emory University Hospital, Atlanta, GA, USA. 3. Department of Orthopedic Surgery, Emory University Hospital, Atlanta, GA, USA. 4. Department of Radiology, University of Miami, Miami, FL, USA. 5. Department of Radiology and Imaging Sciences Section of Musculoskeletal Imaging, Emory University Hospital, 59 Executive Park South, 4th Floor Suite 4009, Atlanta, GA, 30329, USA. Adamsinger82@gmail.com.
Abstract
OBJECTIVES: Compile the largest study to date on the imaging and clinical features of the classic spindle cell/pleomorphic lipoma spectrum and suggest this diagnosis be included in the differential for benign and malignant macroscopic fat-containing soft tissue masses regardless of the mass location or patient demographics. MATERIALS AND METHODS: An institutional search was performed to identify all available classic-type spindle cell/pleomorphic lipomas with available demographic and imaging data. Images and reports were analyzed by one MSK-trained radiologist and radiographic, anatomic and clinical data were recorded. Additionally, a literature search was performed to identify studies describing the spindle cell lipoma spectrum imaging features and were combined with institutional data. RESULTS: Forty-two institutional cases were identified, 37 of which had MRIs performed among which 21 had images available (T1- and T2-weighted pulse sequences) for review while the remainder had outside reports detailing the mass imaging features. There was a mean age of 57 with 79% of cases occurring in males. Contrary to prior reports, 57% of masses were subcutaneous, and the neck and back region accounted for 26% of cases. When the institutional cases were combined with available data in the literature, there was a new sample size of 91 masses, 74 of which had MRI and/or CT data. Eighty-seven percent of masses were heterogeneous, 51% were composed of less than 75% fat, 65% were in the back, neck or shoulder region, 27% of masses were deep and 91% demonstrated enhancement. Eighty-two percent of patients were males with a mean age of 58 at excision. CONCLUSION: Imaging features, patient demographics and tumor location alone are not enough to differentiate tumors of the spindle cell lipoma spectrum from other macroscopic fat-containing benign and malignant tumors, and these entities should be included in the same imaging differential diagnosis.
OBJECTIVES: Compile the largest study to date on the imaging and clinical features of the classic spindle cell/pleomorphic lipoma spectrum and suggest this diagnosis be included in the differential for benign and malignant macroscopic fat-containing soft tissue masses regardless of the mass location or patient demographics. MATERIALS AND METHODS: An institutional search was performed to identify all available classic-type spindle cell/pleomorphic lipomas with available demographic and imaging data. Images and reports were analyzed by one MSK-trained radiologist and radiographic, anatomic and clinical data were recorded. Additionally, a literature search was performed to identify studies describing the spindle cell lipoma spectrum imaging features and were combined with institutional data. RESULTS: Forty-two institutional cases were identified, 37 of which had MRIs performed among which 21 had images available (T1- and T2-weighted pulse sequences) for review while the remainder had outside reports detailing the mass imaging features. There was a mean age of 57 with 79% of cases occurring in males. Contrary to prior reports, 57% of masses were subcutaneous, and the neck and back region accounted for 26% of cases. When the institutional cases were combined with available data in the literature, there was a new sample size of 91 masses, 74 of which had MRI and/or CT data. Eighty-seven percent of masses were heterogeneous, 51% were composed of less than 75% fat, 65% were in the back, neck or shoulder region, 27% of masses were deep and 91% demonstrated enhancement. Eighty-two percent of patients were males with a mean age of 58 at excision. CONCLUSION: Imaging features, patient demographics and tumor location alone are not enough to differentiate tumors of the spindle cell lipoma spectrum from other macroscopic fat-containing benign and malignant tumors, and these entities should be included in the same imaging differential diagnosis.
Authors: Laura W Bancroft; Mark J Kransdorf; Jeffrey J Peterson; Murali Sundaram; Mark D Murphey; Mary I O'Connor Journal: AJR Am J Roentgenol Date: 2003-11 Impact factor: 3.959
Authors: Hongying Zhang; Michele Erickson-Johnson; Xiaoke Wang; Jennifer L Oliveira; Antonio G Nascimento; Frank H Sim; Doris E Wenger; Renata Q Zamolyi; Vera L Pannain; Andre M Oliveira Journal: Am J Surg Pathol Date: 2010-09 Impact factor: 6.394
Authors: Mark J Kransdorf; Laura W Bancroft; Jeffrey J Peterson; Mark D Murphey; William C Foster; H Thomas Temple Journal: Radiology Date: 2002-07 Impact factor: 11.105
Authors: Alexandra A Ntorkou; Athina C Tsili; Dimitrios Giannakis; Anna Batistatou; Sotirios Stavrou; Nikolaos Sofikitis; Maria I Argyropoulou Journal: J Med Case Rep Date: 2016-03-31