What is the role of radiography in the workup of pleomorphic sarcoma (malignant fibrous histiocytoma) of soft tissue?

Updated: Nov 07, 2018
  • Author: Gregory Scott Stacy, MD; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Answer

Answer

Radiographs may reveal a nonspecific soft-tissue mass (see the image below), often greater than 5 cm in diameter. Deep intramuscular tumors often lie adjacent to the diaphysis of a long bone.

Radiograph demonstrates a soft tissue mass posteri Radiograph demonstrates a soft tissue mass posterior to the femoral diaphysis. Although not appreciated on the radiograph, a component of the mass extends inferiorly and contains a small cluster of calcifications (within circle).

Secondary osseous involvement, including periosteal reaction, cortical erosion, and pathologic fracture, is uncommon but suggestive of a malignant soft-tissue sarcoma.

Calcification or ossification can be detected in 5-20% of patients. Calcifications within the tumor may be punctate, curvilinear, and/or poorly defined.

Heterotopic bone formation may be present in the periphery of the mass.


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