ABSTRACT
Myxoid liposarcoma accounts for 30% to 50% of all liposarcomas, which is the second most common soft tissue tumor. It is usually painless slowly growing mass in the deep-seated soft tissue of the lower extremities or the peritoneum, with a strong metastatic predilection to the spine. Metastatic myxoid liposarcoma typically shows low signal intensity on T1 sequences with hyper-intensities on T2 sequences. In contrast to vertebral hemangioma, it shows increased signal intensity in both T1 and T2 sequences. We demonstrate 2 cases of metastatic myxoid liposarcoma with atypical MRI pattern. According to the histopathology and the clinical signs, we believe that increasing round cell cellularity and fat content is correlated to the increased T1 signal intensity and clinical aggressiveness. In conclusion, the atypical MRI pattern for vertebral metastatic lesions in patients with myxoid liposarcoma should be taken into consideration to prevent the delay in diagnosis and standard of care.