EURORAD ESR

Case 14592

Solitary fibrous tumour of the chest wall

Author(s)
Lerma Gallardo JL, Monte González JC, Bustos García de Castro A, Cabeza Martínez B, Estrada Muñoz L, Ferreiros Domínguez J.

Hospital Clínico San Carlos
Profesor Martín Lagos, S/N
Madrid - 28040, Spain
Email: joseluislermagallardo@gmail.com
 
Patient
female, 75 year(s)
 
 
  • Figure 1
    Ultrasound / Colour Doppler ultrasound

    A) US demonstrates a well-defined slightly heterogeneous hypoechoic solid mass in the right anterolateral thoracoabdominal wall. B) Doppler US shows important vascularization (arrow).

     
    Area of Interest: Thoracic wall; Imaging Technique: Ultrasound; Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Contrast-enhanced CT (arterial phase)

    Contrast-enhanced CT shows a well-defined heterogeneously enhancing lobular mass. Serpiginous linear areas of enhancement consistent with intralesional vessels are shown in the arterial phase (arrow).

     
    Area of Interest: Thoracic wall; Imaging Technique: CT; CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    Contrast-enhanced CT (portal phase)

    Contrast-enhanced CT shows a well-defined heterogeneously enhancing lobular mass. Areas of low attenuation within the lesion consistent with myxoid change, necrosis, or cystic degeneration are noted in the portal...

     
    Area of Interest: Thoracic wall; Imaging Technique: CT; CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    MRI (T1 / T2)

    Axial T1 and T2 MR images show well-defined soft-tissue mass of heterogeneous intermediate signal intensity. Areas of high intensity within the lesion consistent with myxoid change, necrosis, or cystic degeneration...

     
    Area of Interest: Thoracic wall; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 5
    MRI (STIR / T1 + GAD)

    A) Axial STIR MR image. Flow voids corresponding to prominent perilesional feeding vessels are seen within the lesion (arrow). B) Axial contrast-enhanced MR image. Intense heterogeneous enhancement with central...

     
    Area of Interest: Thoracic wall; Imaging Technique: MR; MR-Angiography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 6
    Angiography / 3D volume rendering CT reconstruction

    A) Digital subtraction angiogram shows important feeding vessels from the internal mammary artery (arrow). B) 3D volume rendering CT reconstruction image shows the tumour blood supply from the large and tortuous...

     
    Area of Interest: Thoracic wall; Imaging Technique: Catheter arteriography; CT-Angiography; Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Embolisation; Special Focus: Neoplasia;
     
     
  • Figure 7
    Intraoperative gross photographs

    A) Intraoperative gross photograph shows a well-circumscribed, encapsulated and highly vascular mass with lobular external surface. B) Intraoperative gross photograph of the vascular pedicle of the mass which...

     
    Area of Interest: Thoracic wall; Imaging Technique: Experimental; Procedure: Intraoperative; Surgery; Special Focus: Neoplasia;
     
     
  • Figure 8
    Pathology

    Hematoxylin-eosin (H-E) photomicrograph. Highly cellular proliferation of spindled cells arranged in a storiform pattern. Staghorn-like vessels are shown (arrow). Immunohistochemical analysis. The tumor has diffuse...

     
    Area of Interest: Thoracic wall; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
A) US demonstrates a well-defined slightly heterogeneous hypoechoic solid mass in the right anterolateral thoracoabdominal wall. B) Doppler US shows important vascularization (arrow).
 
Contrast-enhanced CT shows a well-defined heterogeneously enhancing lobular mass. Serpiginous linear areas of enhancement consistent with intralesional vessels are shown in the arterial phase (arrow).
 
Contrast-enhanced CT shows a well-defined heterogeneously enhancing lobular mass. Areas of low attenuation within the lesion consistent with myxoid change, necrosis, or cystic degeneration are noted in the portal phase (arrows).
 
Axial T1 and T2 MR images show well-defined soft-tissue mass of heterogeneous intermediate signal intensity. Areas of high intensity within the lesion consistent with myxoid change, necrosis, or cystic degeneration are shown on T2 (arrows).
 
A) Axial STIR MR image. Flow voids corresponding to prominent perilesional feeding vessels are seen within the lesion (arrow). B) Axial contrast-enhanced MR image. Intense heterogeneous enhancement with central areas of low intensity (arrows).
 
A) Digital subtraction angiogram shows important feeding vessels from the internal mammary artery (arrow). B) 3D volume rendering CT reconstruction image shows the tumour blood supply from the large and tortuous internal mammary artery (arrow).
 
A) Intraoperative gross photograph shows a well-circumscribed, encapsulated and highly vascular mass with lobular external surface. B) Intraoperative gross photograph of the vascular pedicle of the mass which contains feeding vessels (arrow).
 
Hematoxylin-eosin (H-E) photomicrograph. Highly cellular proliferation of spindled cells arranged in a storiform pattern. Staghorn-like vessels are shown (arrow). Immunohistochemical analysis. The tumor has diffuse positive immunohistochemical result for CD34, CD99 and Bcl-2.
 
 
 
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