Tumor neuroectodérmico primitivo primario de ovario

El tumor neuroectodérmico primitivo del ovario es un sarcoma de tejido blando de células redondas pequeñas, raro y agresivo, de origen neural que generalmente se asocia con una alta morbilidad y mortalidad. La inmunohistoquímica es un complemento útil en el diagnóstico diferencial. Se describe un caso de tumor neuroectodérmico primitivo del ovario en paciente nulípara de 21 años que refería dolor y aumento de la circunferencia abdominal. La ecografía mostró tumoración de contenido heterogéneo sólido-quística que aparentemente se originaba del anexo izquierdo. La resonancia magnética confirmó la presencia de tumoración que se extendía hacia la fosa iliaca izquierda sin afectación de órganos locales ni metástasis regionales o a distancia. Los marcadores tumorales estaban todos dentro del rango normal. Durante la laparotomía se observó tumoración de ovario izquierdo con ovario derecho normal. Se realizó salpingoforectomía izquierda debido al tamaño del tumor, resección en cuña de ovario derecho, linfadenectomía pélvica y omentectomía. El examen histopatológico reveló tumor compuesto por láminas de células redondas. Las células tumorales fueron positivas para cromogranina A, sinatrofisina, vimentina y enolasa específica de neuronas, lo que confirmó el diagnóstico de tumor neuroendocrino primitivo de ovario izquierdo, que se originaba de teratoma quístico inmaduro. La paciente rechazó la quimioterapia postoperatoria.

Primitive neuroectodermal tumor of the ovary is a rare and aggressive small round cell soft tissue sarcoma of neural origin that is usually associated with high morbidity and mortality. Immunohistochemistry is a useful adjunct in the differential diagnosis. We describe a case of a primitive neuroectodermal tumor of the ovary in a 21-yearold nulliparous patient who reported pain and increased abdominal circumference. Ultrasonography showed a solid-cystic heterogeneous tumor apparently originating from the left adnexa. Magnetic resonance imaging confirmed the presence of a tumor extending into the left iliac fossa without local organ involvement or regional or distant metastases. Tumor markers were all within the normal range. During laparotomy, a left ovarian tumor was observed with a normal right ovary. Left salpingo-oophorectomy was performed due the size of the tumor, right ovarian wedge resection, pelvic lymphadenectomy and omentectomy. Histopathologic examination revealed tumor composed of sheets of round cells. The tumor cells were positive for chromogranin A, synaptophysin, vimentin and neuron-specific enolase, which confirmed the diagnosis of a primitive neuroendocrine tumor of the left ovary originating from immature cystic teratoma. The patient refused postoperative chemotherapy.

Myxoma arising from the parotid gland

Myxomas can be divided into two groups: those derived from the facial skeleton, and those derived from external skeletal soft tissue. Soft tissue myxomas of the head and neck are uncommon, with fewer than 50 cases reported. In any form and location, myxoma of parotid gland is rare. We report a case of myxoma arising from the left superficial lobe of the parotid gland with good long-term follow-up after superficial parotidectomy with tumor excision. A 49-year-old man was referred to our department of plastic and reconstructive surgery with a painless palpable mass that had persisted in the left mandible angle region for 2 years. Excision of the facial mass and superficial parotidectomy with facial nerve preservation were performed. The biopsy result was myxoma. Long-term follow-up for 22 months showed favorable results without evidence of recurrence but with temporary facial nerve weakness right after the surgery. Myxoma should be considered as a differential diagnosis when benign tumor of the parotid gland is being considered.

Clinical and pathologic analysis of intermediate fibroblastic/myofibroblastic tumors in infants and young children / 中华实用儿科临床杂志

Objective@#To study the incidence and clinicopathological features of intermediate fibroblastic/myofibroblastic tumors(IF/MFT) in infants and the young children.@*Methods@#All available cases with soft tissue tumors in infants and children were retrieved from the files of Women and Children′s Hospital Affiliated to Qingdao University, from January 2012 to December 2017.The incidence rate of IF/MFT was observed.Cases of IF/MFT were identified and investigated by light microscopy and immunohistochemistry by reviewing the related literature.@*Results@#Among 290 soft tissue tumors, 15 cases(5.2%) were IF/MFT, accounted for 88.2%(15/17 cases) of borderline soft tissue tumors.Twelve cases were male, 3 cases were female, the median age was 8 months, and 4 cases were congenital.Clinically, 11 cases were presented with slow-growing painless masses located in the trunk or extremities.According to histopathology, 9 cases(60.0%) were categorized as infantile fibromatosis(IFM), including 5 cases(33.3%) desmoid-type and 4 cases(26.7%) diffuse-type; 3 cases(20.0%) as lipofibromatosis(LFM); 2 cases(13.3%) as infantile fibrosarcoma(IFS) and 1 case(6.7%) as giant cell fibroblastoma(GCF). All 15 tumors were characterized by the presence of spindle fibroblasts and myofibroblasts with infiltration of the surrounding structures.Immunohistochemically, all the 15 cases were diffusely positive for Vimentin(Vim), but negative for Myogenin, MyoD1, Desmin and S-100.Smooth muscle actin(SMA), β-catenin and Bcl-2 were positive in some cases to a certain degree.The Ki-67 proliferation index was higher in diffuse-type IFM and IFS, the former was 5.0%-20.0%, and the latter was about 20.0%, however, the other cases showed Ki-67 <5.0%.The main clinical treatment was complete or extensive excision.@*Conclusions@#IF/MFT accounts for a high proportion of intermediate soft tissue tumors in infants and young children, mostly seen in male children, and IFM and LFM are the main types.The clinical signs and symptoms associated with these tumors are often nonspecific, and their histopathologic manifestations may overlap.The final diagnosis of IF/MFT must depend on the characteristics of age, location, histopathologic changes and immunohistoche-mical findings.

Diagnostic Approach to a Soft Tissue Mass / 대한정형외과학회잡지

Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.

A Case of Soft Tissue Metastasis in Contralateral Submandibular Space by Regional Recurrence of Lower Lip Cancer / 대한이비인후과학회지

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I–III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

Clinicopathological features of six cases of calcifying aponeurotic fibroma / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic features of calcifying aponeurotic fibroma (CAF). Methods The clinical and pathologic profiles of 6 cases of CAF were retrospectively analyzed. Results CAF appeared a firm, painless and slowly growing mass with a predilection for the distal portions of the extremities in young children and adolescents. Microscopically, the tumor consis-ted mainly of benign appearing spindle cells, chondroid cells and calcific debris. Immunohistochemically, the tumor cells were positive for vimentin, HHF-35, S-100, Calponin and CD68. Conclusion CAF is a rare, locally aggressive fibroblastic lesion. It can make an accurate diagnosis by integrating the clinical location with histopathological features. Repeated minor trauma to the extremities and some embryologic cell nests maybe its pathogenesis.

Clinicopathological features of three cases of spindle cell rhabdomyosarcoma and review of literatures / 临床与实验病理学杂志

Purpose To investigate the clinicopathological characteristics and differential diagnosis of spindle cell rhabdomyosarcoma ( SCRM) . Methods Three cases of SCRMs were analyzed by gross examination, microscopy and immunohistochemistry. Relevant lit-eratures were reviewed to summarize the diagnostic features of SCRM and its differential diagnosis. Results All the 3 cases were male infants aged from 2 days to 4 years. 2 cases were located in paratesticular and 1 in back. Tumors were all well-circumscribed but unen-capsulated, with white-gray cut surface, firmed and sized 2. 0 to 6. 0 cm in diameter. Histologically, tumors displayed invasive growth but were well-circumscribed. Tumor cells were spindle to round with eosinophilic cytoplasm and fascicular, storiform, wavy appear-ance. Horizontal structure and striated muscle brood cells were observed in some cells or local regions. A small amount of collagen fi-brils were observed in the mesenchymal components. The nucleus were long or fine wavy with unconspicuous nuclear atypia, mitosis could be occasional observed. Immunohistochemically, tumor cells were positive for vimentin, desmin, myogenin and MyoD1. CK,α-inhabin, AFP, CD34 and S-100 were negative. Conclusions SCRM is a rare and new type of rhabdomyosarcoma that commonly oc-curred in infant. It should be differentiated from other tumors, such as infantile fibromatosis, congenital fibrosarcoma, fibrosarcoma, leiomyosarcoma, triton tumor, malignant melanoma of promoting the fibrous tissues.

Oral Benign Fibrous Histiocytoma of Chin: A Rare Case Report and Literature Review.

Fibrous histiocytoma is a benign soft tissue neoplasm that may present as a fi brous mass any-where in the human body. Th e involvement of the oral cavity is extremely rare and very few cases have been reported in the literature until date. We here report a case of benign fi brous histiocytoma localized in the oral cavity in mandibular chin region and the treatment approach that need to be followed for such cases. Th e clinical and histological features of the lesion are discussed precisely in the light of a literature review of this pathology occurring in soft tissues in the head and neck region.

Sonographic Features of Common Soft Tissue Masses in the Extremities / 대한정형외과학회잡지

A wide variety of superficial soft tissue masses may be seen in clinical practice and imaging modalities can be helpful in achievement of a definitive diagnosis or limit a differential diagnosis. Among them, ultrasonography is well suited for screening soft tissue masses because of its safety, low cost, and real-time dynamic imaging. The purpose of this article is to review the characteristic sonographic appearance of soft tissue masses in the extremities.

Soft Tissue Masses Showing Low Signal Intensity on T2-weighted Images: Correlation with Pathologic Findings

OBJECTIVE: The aims of this article are to differentiate soft tissue masses showing low signal intensity on T2-weighted images (T2WIs) according to the histopathologic findings. CONCLUSION: To know relatively small numbered soft tissue masses with low signal intensities on T2WIs adding characteristic location, morphology, signal intensities on other sequences might be helpful for differential diagnosis of mostly nonspecific soft tissue tumors on MRI.

Comparison between CT characteristics and histological differentiation of soft tissue sarcomas / 实用放射学杂志

Objective To investigate the relationship between CT characteristics and histological differentiation of soft tissue sar-comas.Methods Forty-two cases with pathologically proved soft tissue sarcomas were collected.The tumor size,morphology,den-sity and relationship of the tumor to the adjacent structures on CT were analyzed retrospectively.The value of the CT signs in evalu-ating the histological differentiation of the tumor was explored.Results The maximal diameter of the tumor was over 5 cm in 36 ca-ses.Oval shape was seen in 29 cases and irregular shape was seen in 13 cases.Heterogeneous density was seen in 32 cases including intratumoral calcification in 3 cases and intratumoral necrosis in 22 cases.Adjacent structures were infiltrated in 25 cases.Compared to the pathological results,intratumoral necrosis and invasion of adjacent structures were related to the degree of histological differ-entiation (P <0.05),and the relation coefficients were 0.64 and 0.57,respectively (P <0.01).Conclusion Intratumoral necrosis and invasion of adjacent structures are correlated with the histological differentiation of the soft tissue sarcomas.They may reflect the biological behavior of low-differentiated or undifferentiated soft tissue sarcomas to some extent.

Intrathoracic hibernoma: an uncommon tumour / Hibernoma intratorácico: un tumor poco frecuente

Hibernomas are uncommon benign tumours that arise from the remnants of fetal brown adipose tissue. They are usually asymptomatic and have a slow growth pattern. Intrathoracic and pleural locations are exceptional for localization of hibernoma. A review of the English language medical literature revealed more than 110 cases, 20 of which were intrathoracic. In the article below, we discuss a 40-year old male patient who had pleural involvement and was treated by surgical resection. Following resection, the patient has remained problem-free for nine years.

Los hibernomas son tumores benignos poco frecuentes que surgen de restos del tejido adiposo marrón fetal. Son generalmente asintomáticos y tienen un patrón de crecimiento lento. Las localizaciones intratorácicas y pleurales son excepcionales para la localización del hibernoma. Una revisión de la literatura médica en lengua inglesa reveló más de 110 casos, 20 de los cuales se trataban de hibernomas intratorácicos. En el siguiente artículo, discutimos el caso de un paciente de 40 años de edad, que tenía una afección pleural y fue tratado con una resección quirúrgica. Después de la resección, el paciente ha permanecido sin problemas durante nueve años.

Lipoma in Floor of Mouth.

Lipomas are adipose mesenchymal neoplasms, they are relatively uncommon in the oral cavity, representing about 0.5% to 5% of all benign oral tumors1. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium is intact, and superficial blood vessels are usually evident over the tumour. We report a case with an unusual and atypical presentation of the lipomas in the floor of mouth, which is quite a rare site in the literature even in the oral cavity lipomas.

Soft Tissue Masses in the Extremities: The Accuracy of an Ultrasonographic Diagnosis

PURPOSE: We wanted to retrospectively determine the accuracy of an ultrasonographic diagnosis of superficial soft tissue masses in the extremities by using the histologic results as the reference standard. MATERIALS AND METHODS: From January 2005 to June 2010, 154 patients with soft tissue masses in the extremities and who underwent ultrasonographic evaluation followed by biopsy or resection were retrospectively evaluated. The ultrasonographic and histologic diagnoses of the soft tissue masses were lipoma, ganglion cyst, hemangioma, neurogenic tumor, giant cell tumor of the tendon sheath, epidermoid cyst, fibroma, glomus tumor, Baker's cyst and neurofibromatosis. RESULTS: Out of 154 patients, 114 (74%) patients showed concordance between the histologic diagnosis and the ultrasonographic diagnosis, and the remaining 40 (26%) patients did not. The diagnostic accuracy of each soft tissue mass was 95% for lipoma, 83% for ganglion cyst, 75% for hemangioma, 72% for neurogenic tumor, 50% for giant cell tumor of the tendon sheath, 43% for epidermoid cyst, 33% for fibroma and 100% each for glomus tumor, fibromatosis and Baker's cyst. Aside from these tumors, there were also sarcoma, malignant melanoma, elastofibroma, Kimura disease and pilomatricoma. Among the cases that showed discordance between the histologic diagnosis and the ultrasonographic diagnosis, three of them were notable; pilomatricoma being misdiagnosed as dermatofibroma protuberans, angiolipoma being misdiagnosed as vascular leiomyoma and malignant fibrous histiocytoma being misdiagnosed as a malignant soft tissue mass. CONCLUSION: The accuracy of an ultrasonographic diagnosis for soft tissue masses in the extremities varies greatly according to each type of mass. Lipoma, ganglion cyst, hemangioma, glomus tumor, neurogenic tumor and Baker's cyst showed a relatively high rate of concordance between the ultrasonographic diagnosis and the histologic diagnosis, but epidermoid cyst and fibroma showed a relatively lower rate of concordance.

Sarcoma epitelióide: aspectos clínicos, fatores prognósticos e sobrevida / Epithelioid sarcoma: clinical behavior, prognostic factors and survival

OBJETIVO: Descrever os aspectos epidemiológicos, clínicos, o tratamento e o prognóstico dos pacientes com sarcoma epitelióide. MÉTODOS: Revisão do prontuário de 25 pacientes matriculados no INCA com o diagnóstico de sarcoma epitelióide, no período de 05 de junho de 1987 à 15 de julho de 2005. RESULTADOS: A idade mediana foi de 33 anos, variando de 10 à 70 anos. A localização primária mais freqüente foi os membros superiores em doze casos (48 por cento). O tamanho do tumor foi descrito em 19 casos e a mediana foi de 5cm, variando de 1,5 à 15cm. A cirurgia foi realizada em dezessete pacientes com onze amputações. As margens cirúrgicas estavam livres em quinze pacientes, comprometidas em três e em sete não foram relatadas. Seis receberam tratamento com algum tipo de quimioterapia e quatorze receberam tratamento com radioterapia com dose mediana de 46,5Gy. Recidiva local ocorreu em treze casos (52 por cento). Recidiva nodal foi diagnosticada em nove pacientes (36 por cento). Metástase pulmonar foi diagnosticada em sete pacientes (28 por cento). Seis pacientes realizaram o tratamento oncológico na sua totalidade no INCA. Atualmente doze estão vivos sem doença, dois estão vivos com doença e onze pacientes foram a óbito. CONCLUSÃO: O sarcoma epitelióide é um subtipo raro de sarcoma de partes moles que apresenta alta taxa de recidiva local, regional e metástase à distância. Incide principalmente nas extremidades de pacientes jovens. O tratamento cirúrgico consiste em ressecção alargada com margens livres.

OBJECTIVE: To relate the clinical characteristics and evaluations of patients with epithelioid sarcomas. METHODS: Careful analysis of 25 epithelioid sarcoma cases registered in Instituto Nacional do Cancer between june 1987 and july 2005. RESULTS: Mean age at diagnosis was 33 years old, ranged from 10 to 70. The primary site of presentation was the upper extremity in twelve patients (48 percent). The size of the tumor was given in 19 cases, with the mean size of 5cm, while they ranged from 1,5 to 15cm. Surgery was made in 17 patients, with eleven amputation. Tumors margins were free in fifteen patients, positive in three and in seven were not studied. Six received any type of quimiotherapy and 14 received treatment with radiotherapy with mean dose of 46,5 Gy. Local recurrence occurred in thirteen cases (52 percent). Nodal spread was diagnosed in nine (36 percent). Pulmonary metastases were diagnosed in seven patients (28 percent). Six patients underwent cancer treatment in its entirety at the National Institute of Cancer. At present twelve patients are alive without disease, two have disease and eleven patients have died. CONCLUSION: Epithelioid sarcoma is a rare subset of soft tissue sarcoma with high rate of local recurrence, regional node and distant metastases. Occurs predominantly in young patients, mainly on the superior member extremities. Surgical treatment of epithelioid sarcoma consists of early wide local resection to negative microscopic margins. These patients require carefully follow-up to evaluate local recurrence, nodal metastases, and pulmonary metastases.

The diagnostic value of delineating deep fascia in distinguishing between benign and malignant soft-tissue tumors in lower limbs using 3.0 T MRI / 中华放射学杂志

Objective To study the diagnostic value of the morphological changes to deep fascia in distinguishing between benign and malignant soft-tissue tumors in lower limbs using 3.0 T MRI. Methods MR images of 40 consecutive patients with 41 pathologically proven soft-tissue tumors of the lower limbs were retrospectively reviewed by two radiologists. Lesions were divided into four groups according to their predominant location with respect to the deep fascia: (1)Subcutaneous lesions superficial to the deep fascia (n=7). (2) Lesions located beneath the deep fascia (n=8). (3) Lesions in the interspaces of the deep fascia investment (n=10). (4) Intramuscular lesions (n=16). The relationship between tumors and the deep fascia and the morphology changes of deep fascia were analyzed. Lesions of groups (1) (2) were considered as superficial lesions, while lesions of group (3) (4) were considered as deeper lesions. The size differences between those had intact deep fascia and those had destructed deep fascia in superficial lesions and in deeper lesions were evaluated by using Mann-Whitney U test, respectively. P values < 0. 05 were considered statistically significant. Results The deep fascial structures were intact in all of the 16 pathologically proven benign lesions. In 23 of the 25 malignant lesions, there was destruction of the deep fascia with the signs of displacement/disruption of the deep fascia and penetrating growth in (1) (2), and displacement/distruption of intermuscular septum as well as involvement of interspaces of the deep fascial investment and loss of integrity of the fascial/muscular planes in (3) (4). Only 2 malignant lesions demonstrate intact deep fascia. In superficial lesions [(1) (2)] , the maximum size were (5.0±3.8) cm (Median ± Interquartile Range) in those had intact deep fascia, and (5.7±6.90) cm in those had destruction signs (T=47.5, P >0.05). In deeper lesions [(3) (4)] the maximum size were (4.6±1.9) cm of those had intact deep fascia, and (13.6±6.5) cm of those had destruction signs (T= 62.5, P <0.01). Distinguish malignant from benign lesions on the signs of destructed deep fascia, the sensitivity, specificity and accuracy were 92.0% (23/25), 100% (16/16), and 95. 1% (39/,41), respectively. Conclusions Tumor involvements and disruption of the deep fascial structures visualized by 3.0 T MR imaging may be of utility in differentiating malignant from benign soft-tissue tumors.

Angiossarcoma cutâneo gigante de região dorsal / Giant cutaneous angiosarcoma on dorsal region

Introdução. O angiossarcoma cutâneo é um tipo raro de sarcoma que ocorre mais comumente em adultos idosos, iniciando-se, frequentemente, como massa nodular cutânea na face ou no pescoço. O padrão de crescimento é usualmente rápido e pode cursar com sangramento persistente. Apresenta comportamento agressivo sendo comum recidiva local ou a distância. O tratamento, em geral, consiste em ressecção ampla com margens livres e radioterapia. Seu prognóstico costuma ser sombrio. Caso. Os autores apresentam um caso deste raro tipo de sarcoma de localização na região dorsal, tratado por ressecção radical e radioterapia adjuvante com boa evolução. Não houve recidiva até o momento após seguimento em dois anos. Conclusão. A despeito de seu comportamento agressivo, o angiossarcoma cutâneo pode ser adequadamente controlado com ressecção tridimensional associada à radioterapia.

Introduction. Cutaneous angiossarcoma is a rare type of sarcoma that may occur in the elderly male. It is presented as a nodular cutaneous mass on the face or the neck. The pattern of growth is usually rapid. Sometimes, persistent bleeding may occur. It presents aggressive behavior being common both local and distant recurrence. Wide resection with free margins plus adjuvant radiotherapy is the best treatment. Habitually, it presents dismal prognosis. Case. The authors present a single case of this rare sarcoma that was treated by means of radical resection plus adjuvant radiotherapy with a good outcome. Resection was R0 (free-margins). There was no recurrence with two years of follow-up period. Conclusion. Despite its aggressive behavior, cutaneous angiosarcoma may be controlled by means of wide resection plus adjuvant radiotherapy.

The comparative study of MR diffusion-weighted imaging and MR perfusion-weighted imaging in diagnosing soft tissue tumors / 中华放射学杂志

Objective To evaluate MR diffusion-weighted imaging (DWI)and MR perfusion-weighted imaging(PWI) in differentiating benign from malignant soft tissue tumors by comparing the related parameters. Methods Fifty patients with soft tissue tumors verified by pathology( benign 24, malignant 26) underwent DWI and dynamic contrast-enhanced T2 * -weighted PWI. DWI and PWI data of benign and malignant soft tissue tumors were acquired at the workstation and their difference was analyzed with t-test. The diagnostic accordance rate was verified with x2-test. Subjective overall performance of two techniques were evaluated with receiver operating characteristic (ROC) analysis. Results ADC values of benign and malignant tumors were (2. 03±0. 36) × 10-3 mm2/s, ( 1.52±0. 39) × 10-3 mm2/s,respectively. The signal intensity decrease of them during the first-pass perfusion (SIdecrease ) were ( 13.54 ± 3.37 )%, (47. 57 ± 5. 21 ) % ,respectively. The maximum linearity slope rate of TIC ( SSmax ) of them were ( 5.51 ± 2. 54 ) %, (7.94 ± 3. 33) %, respectively. There were significant differences between benign and malignant tumors of ADC value and SIdecrease ( t = 2. 515,2. 938 ;P < 0. 05 ), while there was no significant difference in SSmax (t = 1. 272,P >0. 05). When the threshold of ADC value was 1. 866 × mm2/s, sensitivity and specificity for determining malignant tumors were 84. 6% (22/26)and 83.3% (20/24). When the threshold of SIdecrease was 40. 33% ,sensitivity and specificity for determining malignant tumors were 88. 5% (23/26)and 75.0% (18/24). In type Ⅰa of TIC,the proportion of benign soft tissue tumor was 3/24 and malignant tumor was 20/26. In type Ⅰb , benign tumor was 14/24 and malignant tumor was 3/26. In type Ⅰc, malignant tumor was 3/26. In type Ⅱ ,benign tumor was 7/24. The diagnostic accordance rate of DWI and PWI were 84. 0% (42/50) and 82. 0% (41/50), respectively. There was no significant difference between them ( x2 = 0. 8, P >0. 05). The accuracies of them were 81.7% , 83. 6% respectively by the area under the ROC curve (AUC). The sensitivity of PWI in diagnosing malignant soft tissue tumors was higher. Conclusions ADC value and SIdecrease are Valllable diagnostic parameters in differentiating benign and malignant soft tissue tumors. The threshold of these parameters for diagnosing malignant soft tissue tumors are 1. 866 × 10-3 mm2/s and 40. 33%, respectively. The type of TIC can help to distinguish malignant tumors from benign tumors, while the SSmax can not. The accuracies of DWI and PWI in the diagnosis of malignant soft tissue tumors are moderate. Compared with DWI, PWI should be selected firstly because of its higher sensitivity in diagnosing malignant tumors.

Color Doppler Ultrasonographic Findings of Vascular Leiomyoma: Pathologic Correlation

PURPOSE: To evaluate the distribution of color flow signals on color Doppler ultrasonography of vascular leiomyomas and to correlate them with pathologic findings. MATERIALS AND METHODS: We retrospectively analyzed color Doppler ultrasonographic images and pathologic slides of six vascular leiomyomas. We classified the patterns of distribution of color flow signals into localized compact cluster types and non-cluster types, and the pathologic findings into three subtypes: solid, venous and cavernous. RESULTS: All cases showed well-defined homogenous hypoechoic subcutaneous masses on gray-scale ultrasonography. Three cases showed localized compact cluster types on color Doppler ultrasonography, one in each subtype (solid, venous and cavernous). For the three non-cluster types, again there was on in each subtype. In addition, on pathologic analysis the zone of the localized compact cluster of color flow signals coincided with a cluster of larger, vascular caliber masses. CONCLUSIONS: Localized compact clusters of color flow signals on color Doppler ultrasonography were seen in 50% of our cases and correlated with a cluster of larger vascular caliber in the mass. But the pattern of distribution of color flows didn't show a correlation with pathologic type.

Calcifying Aponeurotic Fibroma of the Elbow: A Case Report

Calcifying aponeurotic fibroma is a rare soft tissue tumor that mostly occurs in the distal extremities of children and adolescents. We report here on a case of calcifying aponeurotic fibroma of the right elbow in an 8-year-old boy, and the tumor was diagnosed by surgical excision. The patient complained of painless swelling and mild limitation of the range of motion of the elbow joint. Radiologically, the mass was ill-defined and showed stippled calcification with shallow bony erosion. Microscopically, the tumor was composed of spindle cells with nodular deposits of hyalination and calcification, and these deposits were surrounded by palisading polygonal plump cells. Immunohistochemically, the tumor showed a diffuse positive expression for CD99 and negativity for smooth muscle actin, S-100 protein and CD34. The patient has been well with no signs of recurrence during the 42 months after surgery.