Non-neoplastic soft-tissue masses

Abstract

As a tertiary centre for soft-tissue sarcomas, numerous non-neoplastic masses are referred to our institution. In many cases, review of the imaging allows a confident diagnosis to be made without the need for biopsy. Lesions include anomalous muscles and variants, muscle injury, haematoma, myositis ossificans, aneurysm, abscess, tumoral calcinosis, amyloidosis and elastofibroma. The purpose of this article is to review the imaging characteristics of these non-neoplastic lesions and highlight the features that help differentiate these lesions from a soft-tissue sarcoma.

Benign calcifying fibrous-myofibroblastic tumor mimicking myositis ossificans in a 22-month-old girl

“…In addition to plain radiographs, MRI has proved to be an appropriate investigative modality in the acute stage before the appearance of the characteristic calcifications [1,3,4]. When the typical peripheral ossification is detected radiographically at 4-6 weeks, computed tomography is more sensitive than plain radiography at detecting early mineralization but may not be necessary [3][4][5], although in atypical cases it may be useful because of its ability to demonstrate the peripheral calcified ring and the central low attenuation zone [5]. Ultrasound may also be useful in demonstrating this zonal phenomenon, the most important radiographic hallmark in MOC [1,3,4].…”

“…When the typical peripheral ossification is detected radiographically at 4-6 weeks, computed tomography is more sensitive than plain radiography at detecting early mineralization but may not be necessary [3][4][5], although in atypical cases it may be useful because of its ability to demonstrate the peripheral calcified ring and the central low attenuation zone [5]. Ultrasound may also be useful in demonstrating this zonal phenomenon, the most important radiographic hallmark in MOC [1,3,4]. The presence of a thin radiolucent cleft separating the ossified mass from the adjacent bone cortex might help to differentiate this condition from juxta-cortical osteosarcoma which may appear very similar, but not from extraskeletal osteosarcoma (EOS) [1,2,6].…”

Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report

“…Chest wall hematoma is rare, and the chest wall hematomas that occur without a history of frank trauma can mimic soft tissue tumors (2,5). The common soft tissue tumors and non-neoplastic chest wall masses include peripheral nerve tumors, lipomas, liposarcomas, hemangiomas, elastofibromas, lymphomas, metastases from distant tumors, infectious mass lesions, desmoid tumors and malignant fibrous histiocytomas (1).…”

“…Imaging examinations are usually performed for patients with chest wall masses to establish a diagnosis and to evaluate the anatomic extension of these masses. The classic MRI signal characteristics of hematomas have been described (5). In a chronic hematoma, the persistence of high signal intensity on T1WI may be caused by recurrent hemorrhage.…”

“…Gadolinium-enhanced images can also be used to confirm the identity of the lesion, with an absence of enhancement indicating that the lesion is a hematoma (1,9). Hematomas may show enhancement, but peripherally this is usually a thin rim (5). A hemorrhagic tumor may be distinguished from a hematoma by the demonstration of tumor nodule or an irregular rim of tumor tissue.…”