MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases ... View Full Text


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Article Info

DATE

2000-04

AUTHORS

L. H. De Beuckeleer, A. M. De Schepper, J. E. Vandevenne, J. L. Bloem, A. M. Davies, M. Oudkerk, E. Hauben, E. Van Marck, J. Somville, D. Vanel, L. S. Steinbach, J. M. Guinebretière, P. C. W. Hogendoorn, W. J. Mooi, K. Verstraete, C. Zaloudek, H. Jones

ABSTRACT

Objective. To evaluate MR imaging and pathology findings in order to define the characteristic features of clear cell sarcoma of the soft tissues (malignant melanoma of the soft parts).Design and patients. MR examinations of 21 patients with histologically proven clear cell sarcoma of the musculoskeletal system were retrospectively reviewed and assessed for shape, homogeneity, delineation, signal intensities on T1- and T2-weighted images, contrast enhancement, relationship with adjacent fascia or tendon, secondary bone involvement, and intratumoral necrosis. In 19 cases the pathology findings were available for review and for a comparative MR-pathology study.Results. On T1-weighted images, lesions were isointense (n=3), hypointense (n=7) or slightly hyperintense to muscle (n=11). Immunohistochemical examination was performed in 17 patients. All 17 specimens showed positivity for HMB-45 antibody. In nine of 11 lesions with slightly increased signal intensity on T1-weighted images, a correlative MR imaging-pathology study was possible. All nine were positive to HMB-45 antibody.Conclusions. Clear cell sarcoma of the musculoskeletal system often has a benign-looking appearance on MR images. In up to 52% of patients, this lesion with melanocytic differentiation has slightly increased signal intensity on T1-weighted images compared with muscle. As the presence of this relative higher signal intensity on T1-weighted images is rather specific for tumors displaying melanocytic differentiation, radiologists should familiarize themselves with this rare entity and include it in their differential diagnosis when confronted with a well-defined, homogeneous, strongly enhancing mass with slightly higher signal intensity compared with muscle on native T1-weighted images. More... »

PAGES

187-195

References to SciGraph publications

  • 1996-02. Clear cell sarcoma mimicking peripheral nerve sheath tumor in SKELETAL RADIOLOGY
  • 1998-09. Magnetic resonance imaging of intraspinal melanotic schwannoma in EUROPEAN RADIOLOGY
  • 1997. Lesions of Uncertain Origin in IMAGING OF SOFT TISSUE TUMORS
  • 1987-06. Case report 423 in SKELETAL RADIOLOGY
  • 1995-05. The role of MR imaging in the diagnosis of alveolar soft part sarcoma: a report of 10 cases in SKELETAL RADIOLOGY
  • Journal

    TITLE

    Skeletal Radiology

    ISSUE

    4

    VOLUME

    29

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s002560050592

    DOI

    http://dx.doi.org/10.1007/s002560050592

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1010813490

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/10855466


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    24 schema:description Abstract Objective. To evaluate MR imaging and pathology findings in order to define the characteristic features of clear cell sarcoma of the soft tissues (malignant melanoma of the soft parts).Design and patients. MR examinations of 21 patients with histologically proven clear cell sarcoma of the musculoskeletal system were retrospectively reviewed and assessed for shape, homogeneity, delineation, signal intensities on T1- and T2-weighted images, contrast enhancement, relationship with adjacent fascia or tendon, secondary bone involvement, and intratumoral necrosis. In 19 cases the pathology findings were available for review and for a comparative MR-pathology study.Results. On T1-weighted images, lesions were isointense (n=3), hypointense (n=7) or slightly hyperintense to muscle (n=11). Immunohistochemical examination was performed in 17 patients. All 17 specimens showed positivity for HMB-45 antibody. In nine of 11 lesions with slightly increased signal intensity on T1-weighted images, a correlative MR imaging-pathology study was possible. All nine were positive to HMB-45 antibody.Conclusions. Clear cell sarcoma of the musculoskeletal system often has a benign-looking appearance on MR images. In up to 52% of patients, this lesion with melanocytic differentiation has slightly increased signal intensity on T1-weighted images compared with muscle. As the presence of this relative higher signal intensity on T1-weighted images is rather specific for tumors displaying melanocytic differentiation, radiologists should familiarize themselves with this rare entity and include it in their differential diagnosis when confronted with a well-defined, homogeneous, strongly enhancing mass with slightly higher signal intensity compared with muscle on native T1-weighted images.
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    31 MR examinations
    32 MR images
    33 MR imaging
    34 T1
    35 T1-weighted images
    36 T2-weighted images
    37 adjacent fascia
    38 antibodies
    39 appearance
    40 bone involvement
    41 cases
    42 cell sarcoma
    43 characteristic features
    44 clear cell sarcoma
    45 contrast enhancement
    46 delineation
    47 design
    48 diagnosis
    49 differential diagnosis
    50 differentiation
    51 enhancement
    52 entities
    53 examination
    54 fascia
    55 features
    56 findings
    57 high signal intensity
    58 homogeneity
    59 hypointense
    60 images
    61 imaging
    62 immunohistochemical examination
    63 intensity
    64 intratumoral necrosis
    65 involvement
    66 lesions
    67 literature review
    68 mass
    69 melanocytic differentiation
    70 muscle
    71 musculoskeletal system
    72 necrosis
    73 order
    74 pathology findings
    75 patients
    76 positivity
    77 presence
    78 radiologists
    79 rare entity
    80 relationship
    81 review
    82 sarcoma
    83 secondary bone involvement
    84 shape
    85 signal intensity
    86 soft tissue
    87 specimens
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