Soft-tissue myxomatous lesions: Review of salient imaging features with pathologic comparison

Jonelle M. Petscavage-Thomas, Eric A. Walker, Chika I. Logie, Loren E. Clarke, Dennis M. Duryea, Mark D. Murphey

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Myxoid soft-tissue lesions are a heterogeneous group of benign and malignant mesenchymal tumors with an abundance of extracellular mucoid material. These lesions may mimic cysts on radiologic evaluation because of the high water content, and histopathologic features also overlap. Benign myxoid lesions include intramuscular myxoma, synovial cyst, bursa, ganglion, and benign peripheral nerve sheath tumor, including neurofibroma and schwannoma. Malignant entities include myxoid liposarcoma, myxoid leiomyosarcoma, myxoid chondrosarcoma, ossifying fibromyxoid tumor, and myxofibrosarcoma. Some syndromes are associated with myxoid soft-tissue lesions, such as Mazabraud syndrome in patients with soft-tissue myxomas and fibrous dysplasia. Certain discriminating features, such as intralesional fat in a myxoid liposarcoma, perilesional edema and a rim of fat in soft-tissue myxoma, and the swirled T2-weighted signal intensity and enhancement pattern of aggressive angiomyxoma, assist the radiologist in differentiating these lesions. The presence of an internal chondroid matrix or incomplete peripheral ossification may suggest myxoid chondrosarcoma or ossifying fibromyxoid tumor, respectively. The enteringand-exiting-nerve sign is suggestive of a peripheral nerve sheath tumor. Communication with a joint or tendon sheath and peripheral enhancement may indicate a ganglion or synovial cyst. This article (a) reviews the magnetic resonance, computed tomographic, and ultrasonographic imaging characteristics of soft-tissue myxomatous lesions, emphasizing imaging findings that can help differentiate benign and malignant lesions; (b) presents differential diagnoses; and (c) provides pathologic correlation.

Original languageEnglish (US)
Pages (from-to)964-980
Number of pages17
JournalRadiographics
Volume34
Issue number4
DOIs
StatePublished - Jan 1 2014

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Myxoma
Myxoid Liposarcoma
Synovial Cyst
Nerve Sheath Neoplasms
Chondrosarcoma
Synovial Bursa
Fats
Ganglion Cysts
Neurofibroma
Leiomyosarcoma
Neurilemmoma
Osteogenesis
Ganglia
Tendons
Cysts
Edema
Neoplasms
Differential Diagnosis
Magnetic Resonance Spectroscopy
Joints

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Petscavage-Thomas, Jonelle M. ; Walker, Eric A. ; Logie, Chika I. ; Clarke, Loren E. ; Duryea, Dennis M. ; Murphey, Mark D. / Soft-tissue myxomatous lesions : Review of salient imaging features with pathologic comparison. In: Radiographics. 2014 ; Vol. 34, No. 4. pp. 964-980.
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Soft-tissue myxomatous lesions : Review of salient imaging features with pathologic comparison. / Petscavage-Thomas, Jonelle M.; Walker, Eric A.; Logie, Chika I.; Clarke, Loren E.; Duryea, Dennis M.; Murphey, Mark D.

In: Radiographics, Vol. 34, No. 4, 01.01.2014, p. 964-980.

Research output: Contribution to journalArticle

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AU - Petscavage-Thomas, Jonelle M.

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