The MR features described in this study are useful for distinguishing malignant peripheral nerve sheath tumors from neurofibromas. If a tumor has two or more of the four statistically significant features, it can be considered to be highly suspicious of malignancy and should be subjected to a biopsy for early diagnosis.

Background Myxoid liposarcoma is generally considered a low grade tumor but the presence of areas of round cells exceeding 5% is reportedly associated with a worse prognosis. Whether ''pure'' tumors without round cells are low grade has not been confirmed. While radiotherapy has been used for patients' myxoid liposarcoma it is unclear whether it reduces local recurrences. Questions/purposes We therefore determined the survival, roles of radiotherapy for local control, and prognostic factors of pure myxoid liposarcoma of the extremities and trunk wall. Methods We retrospectively reviewed 53 patients histologically diagnosed with pure myxoid liposarcoma arising in extremities and the trunk wall. Nine patients of the 53 received radiotherapy for primary tumors. Clinical features and prognosis was determined, and various factors were analyzed as to their usefulness as prognostic factors (age, gender, location, size, depth, surgical margin, and adjuvant radiotherapy). The minimum followup was 12 months (mean, 60 months; range, 12-226 months). Results Seven (13%) and 6 (11%) patients developed a local recurrence and distant metastasis, respectively. The 5-and 10-year disease-specific and disease-free survival rates were 90% and 83% and 77% and 77%, respectively.

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These results suggest that radical surgical treatment causing severe functional impairment should be avoided in selected cases on the basis of patient characteristics, and that other novel therapeutic tools may be necessary for patients in whom a higher risk of local recurrence is assumed or severe complications after surgical treatment are predicted.

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