Case report
MRI of alveolar soft-part sarcoma

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Abstract

Alveolar soft-part sarcoma (ASPS) is rare. We present a case of a 30-year-old woman with a 6-month history of a palpable mass in her left thigh. MRI showed an 8-cm mass and a satellite nodule at the left gluteus muscle. The main tumor exhibited an isointense signal on T1-weighted images and high-signal-intensity areas with low-signal-intensity scanty solid components on T2-weighted images. MR angiography showed dilated and tortuous veins around the tumor. Histologic findings were compatible with ASPS.

Introduction

Alveolar soft-part sarcoma (ASPS) is rare, accounting for less than 1% of all soft-tissue sarcomas [1]. The term “alveolar soft-part sarcoma” is referred to the large granular cells dispersed in alveolar-like arrangements separated by vascular channels [2], [3]. Previous authors have reported that ASPS typically shows high-signal-intensity on both T1-weighted and T2-weighted MRI images, with multiple intra- and extra-tumoral signal voids [1], [4], [5]. We report MRI and magnetic resonance angiography (MRA) findings of a 30-year-old woman with histologically proven ASPS in her left upper thigh.

Section snippets

Case Report

A 30-year-old woman complained of swelling of her left upper thigh for 6 months. Exaggeration of swelling with painful sensation was noted 2 months before this admission. She had no history of trauma or any systemic diseases. Physical examination revealed a tender mass without skin color changes over the left upper thigh. Chest radiographs showed multiple tiny nodules in the right lower lung zone. Chest CT scan revealed multiple nodules of uneven size in both lungs consistent with metastasis.

Discussion

Alveolar soft-part sarcoma is a rare soft-tissue malignancy [6], which commonly occurs in women and in the first two decades of life [7]. The tumor most commonly involves the lower limbs, followed by the trunk and upper limbs. Although alveolar soft-part sarcoma grows slowly, metastases have been reported in 20–25% of patients at diagnosis [7]. Metastasis most frequently attacks the lungs, followed by bone and brain [6]. However, lymph node metastases are not common.

An ASPS typically is a

Yu-Dong Chen, MD, completed this article when he was an intern at Taipei Medical University, and later was resident in Radiology at Taipei Medical University—Wan Fang Hospital. Currently he is resident in Radiology at Taipei Veterans General Hospital.

References (11)

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Cited by (13)

  • Primary Intracranial Alveolar Soft-Part Sarcoma: Report of Two Cases and a Review of the Literature

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    Radiologically, primary intracranial ASPS can be considered in the differential diagnosis for invasive meningioma, hemangioma, myeloma, or paraganglioma. Both meningiomas and myelomas appear as isointense to hypointense lesions on T1-weighted imaging and with variable signal intensity on T2-weighted imaging,19 whereas the most consistent MRI finding of ASPS is isointense to hypointense signals relative to muscle on T1-weighted imaging, with isointense to hyperintense signals on T2-weighted imaging.20 This point is not a critical for differential diagnosis, but it can provide clues for further workup.

  • Imaging Findings and Histologic Appearances of Alveolar Soft Part Sarcoma in the Prostate: A Case Report and Review of the Literature

    2015, Clinical Genitourinary Cancer
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    High T2 signal is seen in most malignant masses because of the interstitial fluid, and it is not the specific finding. Multiple signal voids within the lesion can be attributed to vascular proliferation, which has been frequently observed in ASPS.11 It is partly or totally well circumscribed on MRI, which demonstrates that the mass was surrounded by fibrous pseudocapsule.

  • Ultrasonographic and MR Findings of Alveolar Soft Part Sarcoma

    2009, Journal of the Chinese Medical Association

  • Alveolar soft part sarcoma: a case report

    2009, Journal de Radiologie

  • The dynamic contrast enhanced-magnetic resonance imaging and diffusion-weighted imaging features of alveolar soft part sarcoma

    2023, Quantitative Imaging in Medicine and Surgery

  • Orbital alveolar soft part sarcoma: A report of 8 cases and review of the literature

    2018, Oncology Letters
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Yu-Dong Chen, MD, completed this article when he was an intern at Taipei Medical University, and later was resident in Radiology at Taipei Medical University—Wan Fang Hospital. Currently he is resident in Radiology at Taipei Veterans General Hospital.

Ming-Shium Hsieh, MD, is Chief at Department of Orthopedic Surgery, Taipei Medical University Hospital. Dr. Hsieh is expert in spinal surgery and sport medicine. Dr. Hsieh also is Professor and Director, Faculty of Medicine, Taipei Medical University.

Min-Szu Yao, MD, is staff radiologist at Taipei Medical University—Wan Fang Hospital. Dr. Yao is currently major in musculoskeletal imaging and mammography.

Yun-Ho Lin, MD, is staff pathologist, Department of Pathology, School of Medicine, Taipei Medical University. Dr. Lin is major in bone pathology.

Wing P. Chan, MD, is associate Professor and Chairperson, Department of Radiology, School of Medicine, Taipei Medical University, and Chief, Department of Radiology, Taipei Municipal—Wan Fang Hospital. Dr. Chan is major in musculoskeletal MRI and bone densitometry.

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