Semin Musculoskelet Radiol 2020; 24(06): 645-666
DOI: 10.1055/s-0040-1713606
Review Article

Non-neoplastic Soft Tissue Tumors and Tumor-like Lesions

1   Department of Radiology, University Hospitals of Leicester, Leicester, Leicestershire, United Kingdom
,
Kethesparan Paramesparan
1   Department of Radiology, University Hospitals of Leicester, Leicester, Leicestershire, United Kingdom
,
Philip Robinson
2   Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Leeds, United Kingdom
,
Winston J. Rennie
1   Department of Radiology, University Hospitals of Leicester, Leicester, Leicestershire, United Kingdom
› Author Affiliations

Abstract

Clinicians are commonly faced with patients presenting with a solitary palpable soft tissue mass. Most soft tissue lesions are benign, and not every mass is due to a neoplastic process. Many pathologies can mimic a malignant tumor. Despite appropriate clinicoradiologic assessment, these lesions can be mistaken for a soft tissue sarcoma and can lead to multiple investigations or an intervention, inconveniencing patients and leading to an increased health care cost. With the relevant clinical history, clinical examination, and specific imaging characteristics, the diagnosis can be narrowed. We present a pictorial review of soft tissue sarcoma mimics with guidance on appropriate differential diagnoses.



Publication History

Article published online:
11 December 2020

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  • References

  • 1 Dangoor A, Seddon B, Gerrand C, Grimer R, Whelan J, Judson I. UK guidelines for the management of soft tissue sarcomas. Clin Sarcoma Res 2016; 6: 20
  • 2 Beaman FD, Kransdorf MJ, Andrews TR. et al. Superficial soft-tissue masses: analysis, diagnosis, and differential considerations. Radiographics 2007; 27 (02) 509-523
  • 3 Gielen JL, De Schepper AM, Vanhoenacker F. et al. Accuracy of MRI in characterization of soft tissue tumors and tumor-like lesions. A prospective study in 548 patients. Eur Radiol 2004; 14 (12) 2320-2330
  • 4 Paramesparan K, Shah A, Rennie W. Guide to pseudotumours and soft tissue tumour mimics. Orthop Trauma 2017; 31: 204-215
  • 5 Fletcher CDMBJ. WHO Classification of Tumours of Soft Tissue and Bone. 4th ed. Lyon, France: IARC Press; 2013
  • 6 Crundwell N, O'Donnell P, Saifuddin A. Non-neoplastic conditions presenting as soft-tissue tumours. Clin Radiol 2007; 62 (01) 18-27
  • 7 Glaziou P, Floyd K, Raviglione M. Trends in tuberculosis in the UK. Thorax 2018; 73 (08) 702-703
  • 8 Androulaki A, Papathomas TG, Liapis G. et al. Inflammatory pseudotumor associated with Mycobacterium tuberculosis infection. Int J Infect Dis 2008; 12 (06) 607-610
  • 9 De Backer AI, Vanhoenacker FM, Sanghvi DA. Imaging features of extraaxial musculoskeletal tuberculosis. Indian J Radiol Imaging 2009; 19 (03) 176-186
  • 10 Yuan WH, Hsu HC, Lai YC. et al. Differences in sonographic features of ruptured and unruptured epidermal cysts. J Ultrasound Med 2012; 31 (02) 265-272
  • 11 Hong SH, Chung HW, Choi JY. et al. MRI findings of subcutaneous epidermal cysts: emphasis on the presence of rupture. AJR Am J Roentgenol 2006; 186 (04) 961-966
  • 12 Ando A, Hatori M, Hagiwara Y, Isefuku S, Itoi E. Imaging features of foreign body granuloma in the lower extremities mimicking a soft tissue neoplasm. Ups J Med Sci 2009; 114 (01) 46-51
  • 13 Soudack M, Nachtigal A, Gaitini D. Clinically unsuspected foreign bodies: the importance of sonography. J Ultrasound Med 2003; 22 (12) 1381-1385
  • 14 Peterson JJ, Bancroft LW, Kransdorf MJ. Wooden foreign bodies: imaging appearance. AJR Am J Roentgenol 2002; 178 (03) 557-562
  • 15 Bencardino JT, Rosenberg ZS, Brown RR, Hassankhani A, Lustrin ES, Beltran J. Traumatic musculotendinous injuries of the knee: diagnosis with MR imaging. Radiographics 2000; 20 (Spec No): S103-S120
  • 16 Scolaro JA, Chao T, Zamorano DP. The Morel-Lavallée lesion: diagnosis and management. J Am Acad Orthop Surg 2016; 24 (10) 667-672
  • 17 Beckmann NM, Cai C. CT incidence of Morel-Lavallee lesions in patients with pelvic fractures: a 4-year experience at a level 1 trauma center. Emerg Radiol 2016; 23 (06) 615-621
  • 18 Robinson P, Farrant JM, Bourke G, Merchant W, McKie S, Horgan KJ. Ultrasound and MRI findings in appendicular and truncal fat necrosis. Skeletal Radiol 2008; 37 (03) 217-224
  • 19 Chan LP, Gee R, Keogh C, Munk PL. Imaging features of fat necrosis. AJR Am J Roentgenol 2003; 181 (04) 955-959
  • 20 Ilaslan H, Joyce M, Bauer T. et al. Decubital ischemic fasciitis: clinical, pathologic, and MRI features of pseudosarcoma. AJR Am J Roentgenol 2006; 187 (05) 1338-1341
  • 21 Padmanaban D, Rangasami R, Chandrasekharan A, Swaminathan R. Decubital ischemic fasciitis presenting in an unusual location. Radiol Case Rep 2015; 6 (04) 590
  • 22 Fukunaga M. Atypical decubital fibroplasia with unusual histology. APMIS 2001; 109 (09) 631-635
  • 23 Caulfield RH, Maleki-Tabrizi A, Khan F. et al. A large encapsulated seroma presenting as a mass 5 years post paraumbilical hernia repair. J Plast Reconstr Aesthet Surg 2009; 62 (01) 105-107
  • 24 Albert S, Daniel S, Gouse M, Cherian VM. Case of pseudoaneurysm mimicking a soft tissue sarcoma: a diagnostic pitfall. Malays J Med Sci 2015; 22 (02) 61-64
  • 25 Katzenschlager R, Ugurluoglu A, Ahmadi A. et al. Incidence of pseudoaneurysm after diagnostic and therapeutic angiography. Radiology 1995; 195 (02) 463-466
  • 26 Navarro OM, Laffan EE, Ngan BY. Pediatric soft-tissue tumors and pseudo-tumors: MR imaging features with pathologic correlation: part 1. Imaging approach, pseudotumors, vascular lesions, and adipocytic tumors. Radiographics 2009; 29 (03) 887-906
  • 27 Flors L, Leiva-Salinas C, Maged IM. et al. MR imaging of soft-tissue vascular malformations: diagnosis, classification, and therapy follow-up. Radiographics 2011; 31 (05) 1321-1340 ; discussion 1340–1341
  • 28 Fayad LM, Hazirolan T, Bluemke D, Mitchell S. Vascular malformations in the extremities: emphasis on MR imaging features that guide treatment options. Skeletal Radiol 2006; 35 (03) 127-137
  • 29 Flors L, Park AW, Norton PT. et al. Soft-tissue vascular malformations and tumors. Part 1: classification, role of imaging and high-flow lesions. Radiologia 2019; 61 (01) 4-15
  • 30 Mulligan PR, Prajapati HJ, Martin LG, Patel TH. Vascular anomalies: classification, imaging characteristics and implications for interventional radiology treatment approaches. Br J Radiol 2014; 87 (1035): 20130392
  • 31 Olivieri B, White CL, Restrepo R, McKeon B, Karakas SP, Lee EY. Low-flow vascular malformation pitfalls: from clinical examination to practical imaging evaluation—part 2, venous malformation mimickers. AJR Am J Roentgenol 2016; 206 (05) 952-962
  • 32 Sobhani Eraghi A, Athari B, Kheirkhah Rahimabad P. Tumoral calcinosis of the foot: an unusual differential diagnosis of calcaneal mass. Int J Surg Case Rep 2015; 10: 219-222
  • 33 Olsen KM, Chew FS. Tumoral calcinosis: pearls, polemics, and alternative possibilities. Radiographics 2006; 26 (03) 871-885
  • 34 Blacksin MF, Ha DH, Hameed M. et al. Superficial soft-tissue masses of the extremities. Radiographics 2006; 26 (05) 1289-1304
  • 35 Beltran LS, Rosenberg ZS, Mayo JD. et al. Imaging evaluation of developmental hip dysplasia in the young adult. AJR Am J Roentgenol 2013; 200 (05) 1077-1088
  • 36 Morganroth PA, Chaffins ML, Lim HW. Subcutaneous nodules on the fingers. JAMA Dermatol 2013; 149 (02) 223
  • 37 Al-Ani Z, Oh TC, Macphie E, Woodruff MJ. Sarcoid tenosynovitis, rare presentation of a common disease. Case report and literature review. J Radiol Case Rep 2015; 9 (08) 16-23
  • 38 Wu JS, Hochman MG. Soft-tissue tumors and tumorlike lesions: a systematic imaging approach. Radiology 2009; 253 (02) 297-316
  • 39 Shah A, Botchu R, Dunlop D, Davies AM, James SL. Metal-on-metal total hip arthroplasty associated with adverse local tissue reaction and pseudoaneurysm of the superior gluteal artery: a case report and literature review. Surg J (N Y) 2016; 2 (04) e113-e118
  • 40 Thomas MS, Wimhurst JA, Nolan JF, Toms AP. Imaging metal-on-metal hip replacements: the Norwich experience. HSS J 2013; 9 (03) 247-256
  • 41 Steck WD, Helwig EB. Cutaneous endometriosis. Clin Obstet Gynecol 1966; 9 (02) 373-383
  • 42 Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases. Am J Surg 2008; 196 (02) 207-212
  • 43 Waldman I, Deimling T, Harkins G. Abdominal wall endometriosis: a multidisciplinary approach. J Minim Invasive Gynecol 2015; 22 (6S): S51