Pictorial Review of Trunk and Extremity Myxofibrosarcoma with Emphasis on Magnetic Resonance Imaging

Purpose or Learning Objective: To review trunk and extremity myxofibrosarcoma with emphasis on magnetic resonance imaging (MRI).

Methods or Background: Myxofibrosarcoma (MFS) is a malignant soft tissue sarcoma that usually presents as a painless slow growing mass in the extremities.

Results or Findings: The locally invasive growth pattern of MFS unfortunately means that complete excision is often challenging, with a high incidence of positive surgical margins and local recurrence. Imaging appearances can often mimic benign cystic lesions, but its growth along fascial planes, so-called tumor tails, is a characteristic sign that can allow differentiation. MFS often displays heterogeneous features on MRI with varying myxoid signal. Metastases often involve the lung, and various treatment strategies have been suggested, usually involving radiotherapy.

Conclusion: We review the imaging characteristics of MFS on MRI, discussing pertinent features that should aid the radiologist in suggesting MFS as a potential diagnosis. Posttreatment imaging features of local recurrence are also highlighted. This pictorial review should help increase the radiologist's confidence in diagnosing this challenging entity and help streamline treatment strategies.

Publication History

Article published online:
26 May 2023