Magnetic resonance imaging for soft tissue tumors in comparison to histopathology


Author(s): Sanaa Jawad Kadhim*, Tara Farooq Kareem, Sahar Ahmed Mahdi

Background: Soft tissue masses are frequently referred for imaging assessment. Magnetic Resonance Imaging (MRI) is the technique of choice for characterization and local staging of a soft tissue masses. Objectives: The study aimed to assess the utility of MRI in differentiating benign from malignant Soft Tissue Tumors (STTs).Methods: A prospective study was conducted in the Radiology Department of the Oncology Teaching Hospital, Baghdad Medical City complex. A total of 37 patients were enrolled during the period from 12th July 2019 to 20th February 2020. The study sample consisted of 12 male and 25 female. MRI examination was performed utilizing the 1.5 Tesla Siemens system (Germany). Results: The mean age of participants was 37.65 ± 16.59 years. The benign STTs were recorded in 15 (40.5%), while malignant tumors found in 22 (59.5%) of patients. The majority was on the left lower limb as 10 (27%). Those with tumor mass size below 5 cm were 8 (21.6%), whereas those above or equal to 5 cm were 29 (78.4%). The mean masses size was 10.2 ± 6.43 cm, with median size reached to 8.8 cm. The histopathological diagnosis of masses were achieved either by excisional biopsy in 28 (75.7%) or by true-cut biopsy in 9 (24.3%). The results of histopathology were: 16.2% hemangioma, 13.5% benign neurogenic tumor, 10.8% myxoid liposarcoma, 8.1% Malignant Peripheral Nerve Sheath Tumor (MPNST), 5.4% for each B- cell NHL, fibromatosis, pleomorphic sarcoma, and Ewing sarcoma, and 2.7% for each other’s pathology. The most common site for malignant tumor was in lower extremities, (p=0.031). The tumor masses distributions were statistically significant differences among different sites particularly in the lower limbs sites in malignant tumors (p=0.04). The relation between large tumors sizes and malignant pathology was statistically significant differences (p=0.042). The clear fluid non-enhancing component (that represents serous fluid) might be more evident in malignant rather than benign STTs with significant differences (P=0.028). In addition, the immediate enhancement of the tumor had strong association with malignant than benign tumors, (p=0.007). Conclusions: The larger lesion sizes, the higher the probability of being malignancy. Hemangioma was the most common benign STTs diagnosed, while the most common malignant STTs were myxoid liposarcoma.

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Editors List

  • Osamu Tanaka

    Osamu Tanaka
    Assistant Professor,
    Department of Radiation Oncology
    Asahi University Hospital
    Gifu city, Gifu, Japan

  • Maher Abdel Fattah Al-Shayeb

    Department of Surgical Sciences, Ajman University, UAE

  • Andrzej Zdziennicki

    Institute of Gynecology and Obstetrics, Medical University of Lodz, I Clinic of Gynecology and Gynecological Oncology (Lodz, Poland)

  • Krzysztof Urbanski

    Head of the Oncology Gynecology Clinic, Oncology Center - Instytut im. Maria Sklodowska Curie, Department in Krakow (Krakow, Poland)

  • Andrzej Szawlowski

    Klinika Nowotworow Gornego Odcinka Uklad Digestii, Oncology Center - Institute (Warsaw, Poland)