PLAIN RADIOGRAPHS OF SOFT TISSUE SARCOMA

Abstract

Aim: To describe the radiographic findings of soft tissue sarcoma.

Materials and Method: The retrospective review of 100 consecutive patients with a histological diagnosis of primary soft tissues sarcoma of the extremities.

Results: Fifty five patients had plain radiographs at initial presentation. This was mainly due to the fact that most patients were tertiary referrals or had other initial imaging. Histological diagnosis in these patients was: liposarcoma in 24 patients, leiomyosarcoma in 8, undifferentiated spindle cell sarcoma in 5, malignant schwannoma in 4, synovial sarcoma in 4, MFH in 2, fibrosarcoma in 2, haemangiopericytoma, epithelioid sarcoma, malignant GCT, melanoma and spindle cell histiocytoma in one. The upper limb was involved in 18 patients and the lower limb was involved in 37. Thirty-five (63.6%) patients had a visible soft tissue mass on plain film. Eleven had mineralisation within the soft tissue mass and seven had either bone involvement or periosteal response. Those with a distinct soft tissue mass and evidence of fat content on plain film were noted to be diagnosis of liposarcoma in 86.7% of the cases. Mineralization was noted in synovial sarcoma (2), liposarcoma (3), leiomyosarcoma (1), MFH (2) and poorly differentiated sarcomas (2).

Conclusion: The plain radiograph is useful in assessing soft tissue tumour and abnormality is seen in 2/3 of cases reviewed. Mineralization as a radiographic finding features in malignant sarcoma notably liposarcoma. With tumours demonstrating fat on plain film this can correlate with MRI and facilitate surgical treatment avoiding biopsy.