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DOI: 10.1148/rg.254045204
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Right arrow Musculoskeletal Radiology

Dedifferentiated Liposarcoma of Soft Tissue with High-Grade Osteosarcomatous Dedifferentiation1

Liyuan Yu, MD, Sungmi Jung, MD, Leonard Hojnowski, MD and Timothy Damron, MD

1 From the Departments of Radiology (L.Y., L.H.), Pathology (S.J.), and Orthopedics (T.D.), State University of New York–Upstate Medical School, 750 E Adams St, Syracuse, NY 13210. Received November 24, 2004; revision requested January 3, 2005, and received February 16; accepted February 25. All authors have no financial relationships to disclose.


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  		Figure 1.  Frontal radiograph of the left thigh shows a large heavily ossified soft-tissue mass (arrow) in the anteromedial aspect of the thigh. There is a cap-shaped lucent area of fat with focal calcifications or mineralization (arrowhead) along the proximal aspect of the mass. The underlying femur is unremarkable.

 


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  		Figure 2.  Anterior bone scans show intense radiopharmaceutical uptake in the large mass at the mid to distal left thigh (arrow). There is less radionuclide uptake in the superior portion of the mass (arrowhead).

 


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  		Figure 3.  Axial spin-echo T1-weighted MR image shows the large extraskeletal mass, which has heterogeneous signal intensity.

 


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  		Figure 4.  Axial MR image obtained after intravenous administration of gadolinium contrast material shows heterogeneous enhancement of the mass.

 


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  		Figure 5.  Coronal T1-weighted MR image shows the lipomatous cap containing focal areas of bone formation or calcifications (arrow) proximal to the primary mass. A similar but less prominent finding is noted along the distal extent of the mass (arrowhead).

 


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  		Figure 6.  Coronal inversion-recovery MR image shows the lipomatous caps proximal and distal to the large heterogeneous extraskeletal mass. The lipomatous caps demonstrate low signal intensity.

 


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  		Figure 7.  Photograph of the gross specimen shows the intramuscular sclerotic bone-forming lesion (arrow) with sharply delineated lipomatous caps (arrowheads).

 


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  		Figure 8.  Photomicrograph (original magnification, x200; hematoxylin-eosin stain) of the lipomatous portion of the tumor shows scattered hyperchromatic and bizarre as well as multinucleated stromal cells (arrows), especially within the fibrous septa, but no typical monovacuolated or multivacuolated lipoblasts.

 


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  		Figure 9.  Photomicrograph (original magnification, x 20; hematoxylin-eosin stain) of the osteosarcomatous portion of the tumor shows hyperchromatic atypical cells (arrows) in the osteoid matrix. A cartilage component is seen on the right.

 




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