Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Case 75 Intraosseous lipoma
- Case 76 Lipoma arborescens
- Case 77 Liposarcoma
- Case 78 Mazabraud syndrome
- Case 79 Neurofibromatosis type I (NF I)
- Case 80 Benign peripheral nerve sheath tumors (PNSTs)
- Case 81 Malignant peripheral nerve sheath tumors (MPNSTs)
- Case 82 Synovial sarcoma
- Case 83 Aggressive fibromatosis (desmoid tumor)
- Case 84 Chondrosarcoma
- Case 85 Pigmented villonodular synovitis (PVNS)
- Case 86 Synovial chondromatosis (osteochondromatosis)
- Case 87 Myositis ossificans
- Case 88 Aneurysmal bone cyst (ABC)
- Case 89 Soft tissue hemangioma
- Case 90 Giant cell tumor (GCT)
- Case 91 Ganglion cyst
- Case 92 Chondroblastoma
- Case 93 Hypertrophic osteoarthropathy
- Case 94 SAPHO syndrome
- Index
- References
Case 81 - Malignant peripheral nerve sheath tumors (MPNSTs)
from Section 12 - Tumors/Miscellaneous
Published online by Cambridge University Press: 05 July 2013
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Case 75 Intraosseous lipoma
- Case 76 Lipoma arborescens
- Case 77 Liposarcoma
- Case 78 Mazabraud syndrome
- Case 79 Neurofibromatosis type I (NF I)
- Case 80 Benign peripheral nerve sheath tumors (PNSTs)
- Case 81 Malignant peripheral nerve sheath tumors (MPNSTs)
- Case 82 Synovial sarcoma
- Case 83 Aggressive fibromatosis (desmoid tumor)
- Case 84 Chondrosarcoma
- Case 85 Pigmented villonodular synovitis (PVNS)
- Case 86 Synovial chondromatosis (osteochondromatosis)
- Case 87 Myositis ossificans
- Case 88 Aneurysmal bone cyst (ABC)
- Case 89 Soft tissue hemangioma
- Case 90 Giant cell tumor (GCT)
- Case 91 Ganglion cyst
- Case 92 Chondroblastoma
- Case 93 Hypertrophic osteoarthropathy
- Case 94 SAPHO syndrome
- Index
- References
Summary
Imaging description
Radiography is often negative or it shows a non-specific soft tissue mass. As with other soft tissue tumors MRI is the diagnostic modality of choice for imaging malignant peripheral nerve sheath tumors (MPNSTs). The location of the mass in relationship to a deep large nerve trunk is helpful in diagnosing a neurogenic tumor. The tumor may appear fusiform in shape and may also be noted to enter and exit a nerve (Figure 81.1). The signal intensity of a MPNST on both T1- and T2-weighted images is non-specific. MPNSTs show low signal intensity similar to muscle on T1-weighted images and heterogeneous increase in signal intensity on T2-weighted images. On gadolinium-enhanced images MPNSTs can show central necrosis (Figure 81.2). Malignant and benign peripheral nerve sheath tumors cannot be reliably distinguished on the basis of imaging criteria alone; however certain findings should raise the suspicion that the tumor is malignant. MPNSTs tend to be larger tumors, typically more than 5 cm. They may exhibit ill-defined margins due to infiltration of adjacent soft tissues and are often associated with soft tissue edema. An infiltrative tumor border on CT or MR suggests malignancy, but may be present also in benign plexiform neurofibromas. Conversely a malignant neoplasm may have a smooth, non-infiltrating margin. Bone erosions may occur with both benign and malignant neoplasm, but are more irregular with malignant lesions.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 187 - 190Publisher: Cambridge University PressPrint publication year: 2013