Imaging in retroperitoneal soft tissue sarcoma

Messiou, Christina; Morosi, Carlo

doi:10.1002/jso.24891

Cited by 44 publications

(55 citation statements)

References 46 publications

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“…The latter location represents a poorer prognosis [ 3 ]. Most of the time, Retroperitoneal liposarcomas, are incidentally found on non-related imaging of the abdomen, and they are usually asymptomatic despite their large size, but can later lead to abdominal pain, a palpable mass, or bowel obstruction [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Well-differentiated and dedifferentiated liposarcomas consist 40% of the retroperitoneal sarcomas in adults aged over 55 years. Differential diagnosis of retroperitoneal soft tissue masses includes undifferentiated pleomorphic sarcoma, synovial sarcoma, solitary fibrous tumor, extraosseous Ewing's sarcoma, and malignant peripheral nerve sheath tumor [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…On ultrasonography, liposarcomas are classically hyperechoic [ 5 ]. Calcification can be present and they usually indicates poor prognosis and dedifferentiation, or represent inflammatory or a sclerosing variant of the well differentiated liposarcoma [ 4 ]. MRI is thought to be more sensitive in detecting retroperitoneal liposarcomas [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…MRI is thought to be more sensitive in detecting retroperitoneal liposarcomas [ 5 ]. FDG PET/CT is not used in the routine diagnosis of these lesions due to the vast variability of histological types and tumor grading [ 4 ]. Certain subtypes have metastatic potential [ 3 ], so a full staging CT scan may be required [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Recurrent giant retroperitoneal liposarcoma with 10 years follow up. Case report and review of literature

El-Helou

Alimoradi

Sabra

et al. 2020

International Journal of Surgery Case Reports

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Highlights Liposarcomas are a malignant transformation of fat tissue, found in two major subtypes according to their differentiation. Enhanced CT is essential for diagnosis and confirmed by percutaneous large core needle guided biopsies. Surgery remains the standard practice in treating non-metastatic liposarcomas. No clear definition for giant liposarcoma, Only 52 cases reported between 1998 and July 2020. Our patient has the longest reported follow up in the literature of 10 years, with 3 operations and 3 recurrences.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Recurrent giant retroperitoneal liposarcoma with 10 years follow up. Case report and review of literature

El-Helou

Alimoradi

Sabra

et al. 2020

International Journal of Surgery Case Reports

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“…Although the amplification of the 12q13-15 region, carrying the MDM2 andCDK4 genes, is used to distinguish WD/DDLPS and ALT from benign lipomas and from other types of liposarcomas, specific aberrations that can be used to distinguish between WDLPS and DDLPS subtypes have not been identified so far. Computed tomography (CT) can identify non-lipomatous area in a lipomatous tumor but does not have the resolution to reveal ongoing dedifferentiation processes within adipose-like tissue or to distinguish dedifferentiated parts of the tumor from stroma components, while PET/CT has no routine role for diagnosis [8].…”

Section: Introductionmentioning

confidence: 99%

Accurate 3-gene-signature for early diagnosis of liposarcoma progression

et al. 2020

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Background: Well-and dedifferentiated liposarcoma (WD/DDLPS) are rare mesenchymal malignant tumors that account for 20% of all sarcomas in adults. The WD form is a low-grade malignancy with a favourable prognosis which may progress to DDLPS, a high-grade aggressive counterpart. WDLPS is referred to as atypical lipomatous tumour (ALT) when localised in extremities, due to its better prognosis. Currently the final differential diagnosis to distinguish between more aggressive and less aggressive form is based on post-surgical histological examination and no molecular biomarkers for early detection are available. Methods: Quantitative polymerase chain reaction (qPCR) analysis of 11 metabolic genes involved in general and adipose tissue-specific metabolism, was performed on ALT (= 8), WDLPS (= 9) and DDLPS (= 20) samples. Subsequent statistical analysis was carried out to determine genes that most accurately can predict DDLPS differential diagnosis. Selected genes were further validated in a separate cohort by qPCR and the data statistically analysed. Deep sequencing was performed on DDLPS specimen from the metastatic patient and on five random WDLPS specimens. Results: We established a three-gene signature based on PNPLA2, LIPE and PLIN1, which identified DDLPS with 100% sensitivity and 90% specificity, even in specimens from the WD component of DDLPS tumors. Interestingly, the PNPLA2 gene is deleted in 45% of DDLPS samples analyzed under TCGA project, and the deletion is associated with significantly lower PNPLA2 expression level. However, other mechanisms causing loss or downregulation of the expression of these three genes may be involved. Moreover, the significantly lower level of PNPLA2 is associated with R1 surgical margins, compare to R0 margins, which suggests the more invasive tumor phenotype in the absence of PNPLA2. Conclusions: The identified metabolic signature allows highly accurate differential diagnosis between WD-and DDLPS even in samples containing lipid droplets, a marker of differentiation, which makes it very suitable for the use on biopsies. In respect to the pathogenesis of the disease, our results give a new insight into possible molecular mechanisms involved and support the recent observation that deletion of PNPLA2 is a novel factor in liposarcoma progression.

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Reliability and accuracy in radiographic measurements of musculoskeletal tumors

Kellish

Miskiel

Gaughan

et al. 2021

Journal Orthopaedic Research

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Tumor size and growth are important parameters when evaluating bone and soft tissue neoplasms. There are no reports comparing the intra‐ and interobserver reliability among physicians in their evaluation of musculoskeletal (MSK) tumor imaging. This study investigates the accuracy and precision of measurements made by orthopedic and radiology physicians in different stages of training. Blinded magnetic resonance imaging (MRI) scans from six patients, three soft tissue, and three bone tumors were selected: each case included an “old” and “new” scan that was performed at least 3 months apart. Fourteen participants were selected, representing varying levels of education and experience, including two of each of the following: medical students, orthopedic and radiology residents, oncology and nononcologic orthopedic attendings, and MSK and non‐MSK radiology attendings. Participants compared the old and new studies, recording tumor size in the transverse, cranial–caudal, and anterior–posterior dimensions, and determined if the tumor was stable or unstable. The MRI's official report served as the “gold standard.” Average intraobserver variability (|Trial 1 − Trial 2|/[(Trial 1 + Trial 2)/2])) in size measurements was 11.08% (0.00%–68.62%). The lowest variability was recorded by the MSK radiologist 1 (6.16%), and the greatest variability by Orthopedic Surgery Resident 1 (16.70%). Participants correctly determined stability 82% of the time (71%–100%). Only MSK radiologists correctly determined stability in over 90% of cases. There is considerable variability and inaccuracy in MRI‐based measurements of MSK tumors. These findings motivate opportunities for improving MSK imaging education of radiology and orthopedic residents. Physicians ordering MRI scans should evaluate them themselves, instead of relying on the radiology report alone, to inform clinical decision‐making.

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Imaging in retroperitoneal soft tissue sarcoma

Cited by 44 publications

References 46 publications

Recurrent giant retroperitoneal liposarcoma with 10 years follow up. Case report and review of literature

Recurrent giant retroperitoneal liposarcoma with 10 years follow up. Case report and review of literature

Accurate 3-gene-signature for early diagnosis of liposarcoma progression

Reliability and accuracy in radiographic measurements of musculoskeletal tumors

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