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DOI: 10.1055/s-0041-1723966
Imaging of Pediatric Soft Tissue Tumors and Tumor-like Conditions
Abstract
Lumps and bumps are frequently seen in children, and the vast majority are a result of trauma, infection, or inflammation. True soft tissue neoplastic lesions are rare; however, their wide and complex classifications make these lesions challenging to manage. Imaging features are usually nonspecific, and a reasonable list of differential diagnoses can be generated following consideration of the clinical presentation, age, and anatomical location of the lesion. In this article, we offer a practical approach to diagnosing such lesions by discussing the most common three benign and malignant lesions in different anatomical regions stratified by age with emphasis on certain features that might aid in the diagnosis such as depth, multiplicity, calcification, or other specific imaging feature.
Publication History
Article published online:
21 May 2021
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References
- 1 Kransdorf MJ. Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol 1995; 164 (02) 395-402
- 2 Kransdorf MJ. Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol 1995; 164 (01) 129-134
- 3 Navarro OM, Laffan EE, Ngan BY. Pediatric soft-tissue tumors and pseudo-tumors: MR imaging features with pathologic correlation: part 1. Imaging approach, pseudotumors, vascular lesions, and adipocytic tumors. Radiographics 2009; 29 (03) 887-906
- 4 Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies. Curr Probl Surg 2000; 37 (08) 517-584
- 5 Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982; 69 (03) 412-422
- 6 Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 1983; 18 (06) 894-900
- 7 Gorincour G, Kokta V, Rypens F, Garel L, Powell J, Dubois J. Imaging characteristics of two subtypes of congenital hemangiomas: rapidly involuting congenital hemangiomas and non-involuting congenital hemangiomas. Pediatr Radiol 2005; 35 (12) 1178-1185
- 8 Laor T. MR imaging of soft tissue tumors and tumor-like lesions. Pediatr Radiol 2004; 34 (01) 24-37
- 9 Vandevenne JE, Colpaert CG, De Schepper AM. Subcutaneous granuloma annulare: MR imaging and literature review. Eur Radiol 1998; 8 (08) 1363-1365
- 10 Shah SH, Callahan MJ. Ultrasound evaluation of superficial lumps and bumps of the extremities in children: a 5-year retrospective review. Pediatr Radiol 2013; 43 (Suppl. 01) S23-S40
- 11 Ahn JM, Yoon HK, Suh YL. et al. Infantile fibromatosis in childhood: findings on MR imaging and pathologic correlation. Clin Radiol 2000; 55 (01) 19-24
- 12 Robbin MR, Murphey MD, Temple HT, Kransdorf MJ, Choi JJ. Imaging of musculoskeletal fibromatosis. Radiographics 2001; 21 (03) 585-600
- 13 Cintora E, del Cura JL, Ruiz JC, Grau M, Ereño C. Case report 807: Infantile desmoid-type fibromatosis. Skeletal Radiol 1993; 22 (07) 533-535
- 14 Sargar KM, Sheybani EF, Shenoy A, Aranake-Chrisinger J, Khanna G. Pediatric fibroblastic and myofibroblastic tumors: a pictorial review. Radiographics 2016; 36 (04) 1195-1214
- 15 Murphey MD, Ruble CM, Tyszko SM, Zbojniewicz AM, Potter BK, Miettinen M. From the archives of the AFIP. Musculoskeletal fibromatoses: radiologic-pathologic correlation. Radiographics 2009; 29 (07) 2143-2173
- 16 Stein-Wexler R. Pediatric soft tissue sarcomas. Semin Ultrasound, CT MR 2011; 32 (05) 470-488
- 17 Canale S, Vanel D, Couanet D, Patte C, Caramella C, Dromain C. Infantile fibrosarcoma: magnetic resonance imaging findings in six cases. Eur J Radiol 2009; 72 (01) 30-37
- 18 Wang H, Nie P, Dong C. et al. CT and MRI findings of soft tissue adult fibrosarcoma in extremities. BioMed Res Int 2018; 2018: 6075705
- 19 Laffan EE, Ngan B-Y, Navarro OM. Pediatric soft-tissue tumors and pseudotumors: MR imaging features with pathologic correlation: part 2. Tumors of fibroblastic/myofibroblastic, so-called fibrohistiocytic, muscular, lymphomatous, neurogenic, hair matrix, and uncertain origin. Radiographics 2009; 29 (04) e36
- 20 Farmakis SG, Herman TE, Siegel MJ. Congenital infantile fibrosarcoma. J Perinatol 2014; 34 (04) 329-330
- 21 De Schepper AM, De Beuckeleer LH, Vandevenne JE. Imaging of soft tissue tumors in the pediatric patient. In: Imaging of Soft Tissue Tumors. Berlin, Germany: Springer; 2006: 471-482
- 22 Moukaddam H, Pollak J, Haims AH. MRI_characteristics_and_classification of peripheral vascular malformations and tumors. Skelet Radiol 2009; 38 (06) 535-547
- 23 Gaballah AH, Jensen CT, Palmquist S. et al. Angiosarcoma: clinical and imaging features from head to toe. Br J Radiol 2017; 90 (1075): 20170039
- 24 Hanna SL, Kaste S, Jenkins JJ. et al. Epithelioid sarcoma: clinical, MR imaging and pathologic findings. Skeletal Radiol 2002; 31 (07) 400-412
- 25 Goldblum JR. et al, eds. Enzinger and Weiss's Soft Tissue Tumors. 7th ed. 2020. Chapter Malignant Soft Tissue Tumors of Uncertain type
- 26 McCarville MB, Kao SC, Dao TV. et al. Magnetic resonance and computed tomography imaging features of epithelioid sarcoma in children and young adults with pathological and clinical correlation: a report from Children's Oncology Group study ARST0332. Pediatr Radiol 2019; 49 (07) 922-932
- 27 Casanova M, Ferrari A, Collini P. et al; Italian Soft Tissue Sarcoma Committee. Epithelioid sarcoma in children and adolescents: a report from the Italian Soft Tissue Sarcoma Committee. Cancer 2006; 106 (03) 708-717
- 28 Won KY, Park SY, Jin W, Lew BL. Dermatofibroma: sonographic findings and pathologic correlation. Acta Radiol 2018; 59 (04) 454-459
- 29 Du J, Zhang XT, Yang M, Liu XF, Lin XY. Deep benign fibrous histiocytoma occurring in the kidney: case report. Medicine (Baltimore) 2019; 98 (18) e15150
- 30 Gleason BC, Fletcher CDM. Deep “benign” fibrous histiocytoma: clinicopathologic analysis of 69 cases of a rare tumor indicating occasional metastatic potential. Am J Surg Pathol 2008; 32 (03) 354-362
- 31 Machiels F, De Maeseneer M, Chaskis C, Bourgain C, Osteaux M. Deep benign fibrous histiocytoma of the knee: CT and MR features with pathologic correlation. Eur Radiol 1998; 8 (06) 989-991
- 32 Keasbey LE. Juvenile aponeurotic fibroma (calcifying fibroma); a distinctive tumor arising in the palms and soles of young children. Cancer 1953; 6 (02) 338-346
- 33 Shim SW, Kang BS, Lee CC, Suh JH, Shim HS. MRI features of calcifying aponeurotic fibroma in the upper arm: a case report and review of the literature. Skeletal Radiol 2016; 45 (08) 1139-1143
- 34 Lafferty KA, Nelson EL, Demuth RJ, Miller SH, Harrison MW. Juvenile aponeurotic fibroma with disseminated fibrosarcoma. J Hand Surg Am 1986; 11 (05) 737-740
- 35 Goldblum JR. et al, eds. Enzinger and Weiss’s Soft Tissue Tumors 7th edition. Chapter Fibrous Tumors of Infancy and Childhood
- 36 Fetsch JF, Miettinen M. Calcifying aponeurotic fibroma: a clinicopathologic study of 22 cases arising in uncommon sites. Hum Pathol 1998; 29 (12) 1504-1510
- 37 Kang JH, Lee K, Yoo HJ, Chae HD, Hong SH, Choi JY. Ultrasound and magnetic resonance imaging features of calcifying aponeurotic fibromas. J Ultrasound Med 2020; 39 (07) 1299-1306
- 38 Kim OH, Kim YM. Calcifying aponeurotic fibroma: case report with radiographic and MR features. Korean J Radiol 2014; 15 (01) 134-139
- 39 Yikilmaz A, Ngan BY, Navarro OM. Imaging of childhood angiomatoid fibrous histiocytoma with pathological correlation. Pediatr Radiol 2015; 45 (12) 1796-1802
- 40 Thway K, Fisher C. Angiomatoid fibrous histiocytoma: the current status of pathology and genetics. Arch Pathol Lab Med 2015; 139 (05) 674-682
- 41 McCarville MB, Spunt SL, Skapek SX, Pappo AS. Synovial sarcoma in pediatric patients. AJR Am J Roentgenol 2002; 179 (03) 797-801
- 42 Murphey MD, Gibson MS, Jennings BT, Crespo-Rodríguez AM, Fanburg-Smith J, Gajewski DA. From the archives of the AFIP. Imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics 2006; 26 (05) 1543-1565
- 43 Park K, van Rijn R, McHugh K. The role of radiology in paediatric soft tissue sarcomas. Cancer Imaging 2008; 8: 102-115
- 44 Dickey GE, Sotelo-Avila C. Fibrous hamartoma of infancy: current review. Pediatr Dev Pathol 1999; 2 (03) 236-243
- 45 Lee S, Choi YH, Cheon JE, Kim MJ, Lee MJ, Koh MJ. Ultrasonographic features of fibrous hamartoma of infancy. Skeletal Radiol 2014; 43 (05) 649-653
- 46 Stensby JD, Conces MR, Nacey NC. Benign fibrous hamartoma of infancy: a case of MR imaging paralleling histologic findings. Skeletal Radiol 2014; 43 (11) 1639-1643
- 47 Ji Y, Hu P, Zhang C. et al. Fibrous hamartoma of infancy: radiologic features and literature review. BMC Musculoskelet Disord 2019; 20 (01) 356
- 48 Arndt CAS, Rose PS, Folpe AL, Laack NN. Common musculoskeletal tumors of childhood and adolescence Mayo Clin Proc. 2012; 87 (05) 475-487
- 49 McDowell HP. Update on childhood rhabdomyosarcoma. Arch Dis Child 2003; 88 (04) 354-357
- 50 Kim ST, Kim HJ, Park SW, Baek CH, Byun HS, Kim YM. Nodular fasciitis in the head and neck: CT and MR imaging findings. AJNR Am J Neuroradiol 2005; 26 (10) 2617-2623
- 51 Wang XL, De Schepper AMA, Vanhoenacker F. et al. Nodular fasciitis: correlation of MRI findings and histopathology. Skeletal Radiol 2002; 31 (03) 155-161
- 52 Leung LYJ, Shu SJ, Chan ACL, Chan MK, Chan CHS. Nodular fasciitis: MRI appearance and literature review. Skeletal Radiol 2002; 31 (01) 9-13
- 53 Moholkar S, Sebire NJ, Roebuck DJ. Radiological-pathological correlation in lipoblastoma and lipoblastomatosis. Pediatr Radiol 2006; 36 (08) 851-856
- 54 Bruyeer E, Lemmerling M, Poorten VV, Sciot R, Hermans R. Paediatric lipoblastoma in the head and neck: three cases and review of literature. Cancer Imaging 2012; 12 (03) 484-487
- 55 Sheybani EF, Eutsler EP, Navarro OM. Fat-containing soft-tissue masses in children. Pediatr Radiol 2016; 46 (13) 1760-1773
- 56 Navarro OM. Soft tissue masses in children. Radiol Clin North Am 2011; 49 (06) 1235-1259 ; vi–vii
- 57 Miyashita Y, Ikeda N, Hiraoka K. Primary undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma) of the lung: a case report. Clin Case Rep 2019; 8 (01) 33-37
- 58 Daw NC, Billups CA, Pappo AS. et al. Malignant fibrous histiocytoma and other fibrohistiocytic tumors in pediatric patients: the St. Jude Children's Research Hospital experience. Cancer 2003; 97 (11) 2839-2847
- 59 Paoletti H, Colineau X, Acalet L. et al. Ewing's sarcoma of the soft tissues: apropos of 3 cases and review of the literature. [in French]. J Radiol 1999; 80 (05) 477-482
- 60 Chung EB, Enzinger FM. Infantile myofibromatosis. Cancer 1981; 48 (08) 1807-1818
- 61 Fernandez-Pineda I, Parida L, Jenkins JJ, Davidoff AM, Rao BN, Rodriguez-Galindo C. Childhood hemangiopericytoma: review of St Jude Children's Research Hospital. J Pediatr Hematol Oncol 2011; 33 (05) 356-359
- 62 Rodriguez-Galindo C, Ramsey K, Jenkins JJ. et al. Hemangiopericytoma in children and infants. Cancer 2000; 88 (01) 198-204
- 63 Ferrari A, Casanova M, Bisogno G. et al. Hemangiopericytoma in pediatric ages: a report from the Italian and German Soft Tissue Sarcoma Cooperative Group. Cancer 2001; 92 (10) 2692-2698
- 64 McCarville MB, Kaste SC, Pappo AS. Soft-tissue malignancies in infancy. AJR Am J Roentgenol 1999; 173 (04) 973-977
- 65 Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. From the Archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. 1999; 19 (05) 1253-1280
- 66 Höck M, Zelger B, Schweigmann G. et al. The various clinical spectra of juvenile xanthogranuloma: imaging for two case reports and review of the literature. BMC Pediatr 2019; 19 (01) 128
- 67 Ginat DT, Vargas SO, Silvera VM, Volk MS, Degar BA, Robson CD. Imaging features of juvenile xanthogranuloma of the pediatric head and neck. AJNR Am J Neuroradiol 2016; 37 (05) 910-916
- 68 Shmookler BM, Enzinger FM, Weiss SW. Giant cell fibroblastoma. A juvenile form of dermatofibrosarcoma protuberans. Cancer 1989; 64 (10) 2154-2161
- 69 Soyoon Min MD, Sun-Young Park MD, Jinwon Seo MD, Koh SH, Kwanseop LM. Ultrasound and MRI findings of giant cell fibroblastoma in the abdominal wall: radiologic-pathologic correlations. J Korean Soc Radiol 2020; 81 (01) 237
- 70 Zhang L, Liu QY, Cao Y, Zhong JS, Zhang WD. Dermatofibrosarcoma protuberans: computed tomography and magnetic resonance imaging findings. Medicine (Baltimore) 2015; 94 (24) e1001
- 71 Kransdorf MJ, Meis-Kindblom JM. Dermatofibrosarcoma protuberans: radiologic appearance. AJR Am J Roentgenol 1994; 163 (02) 391-394
- 72 Al Barwani AS, Taif S, Al Mazrouai RA, Al Muzahmi KS, Alrawi A. Dermatofibrosarcoma protuberans: insights into a rare soft tissue tumor. J Clin Imaging Sci 2016; 6 (02) 16
- 73 Torreggiani WC, Al-Ismail K, Munk PL, Nicolaou S, O'Connell JX, Knowling MA. Dermatofibrosarcoma protuberans: MR imaging features. AJR Am J Roentgenol 2002; 178 (04) 989-993
- 74 Martin E, Coert JH, Flucke UE. et al. Neurofibromatosis-associated malignant peripheral nerve sheath tumors in children have a worse prognosis: a nationwide cohort study. Pediatr Blood Cancer 2020; 67 (04) e28138
- 75 Rafailidis V, Kaziani T, Theocharides C, Papanikolaou A, Rafailidis D. Imaging of the malignant peripheral nerve sheath tumour with emphasis οn ultrasonography: correlation with MRI. J Ultrasound 2014; 17 (03) 219-223
- 76 Ducatman BS, Scheithauer BW, Piepgras DG, Reiman HM, Ilstrup DM. Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases. Cancer 1986; 57 (10) 2006-2021
- 77 Sperandio M, Di Poce I, Ricci A. et al. Malignant peripheral nerve sheath tumour: CT and MRI findings. Case Rep Radiol 2013; 2013: 517879
- 78 Lin J, Martel W. Cross-sectional imaging of peripheral nerve sheath tumors: characteristic signs on CT, MR imaging, and sonography. 2001; 176 (01) 75-82
- 79 Bansal AG, Oudsema R, Masseaux JA, Rosenberg HK. US of pediatric superficial masses of the head and neck. Radiographics 2018; 38 (04) 1239-1263
- 80 Swift CC, Eklund MJ, Kraveka JM, Alazraki AL. Updates in diagnosis, management, and treatment of neuroblastoma. Radiographics 2018; 38 (02) 566-580
- 81 Papaioannou G, McHugh K. Neuroblastoma in childhood: review and radiological findings. Cancer Imaging 2005; 5 (01) 116-127
- 82 Chen AM, Trout AT, Towbin AJ. A review of neuroblastoma image-defined risk factors on magnetic resonance imaging. Pediatr Radiol 2018; 48 (09) 1337-1347
- 83 Tay M, Kapur J. Neuroblastoma with primary pleural involvement: an unusual presentation. Pediatr Radiol 2011; 41 (04) 530-533
- 84 Lonergan GJ, Schwab CM, Suarez ES, Carlson CL. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics 2002; 22 (04) 911-934