Diagnostic performance of MRI and histology in assessment of deep lipomatous tumours.
Published: 10th September 2019
Authors: L. Cairncross, H. A. Snow, D. C. Strauss, M. J. F. Smith, O. Sjokvist, C. Messiou et al.
Deep lipomatous tumours can be benign lipomas or intermediate/locally recurring atypical lipomatous tumours (ALTs). Differentiating between these two entities clinically and radiologically is difficult. The aims of this study were to report a series of deep lipomatous tumours, comparing the clinical, radiological and pathological features of ALTs and lipomas; and to predict the likelihood of a lipomatous tumour being ALT based on anatomical site and MRI characteristics.
This was a retrospective review of patients with deep lipomatous tumours presenting over 6 years to a tertiary sarcoma centre, with preoperative MRI, and preoperative or postoperative histology including MDM2 gene analysis. Sensitivity, specificity, predictive values and accuracy in diagnosing ALT were calculated for MRI and histopathological features.
Some 248 patients were included; 81 (32·7 per cent) had a final diagnosis of ALT. ALTs were larger than lipomas (median 19 versus 10 cm; P < 0·001); there was no ALT smaller than 5 cm. A tumour presenting in the lower limb was more likely to be an ALT than a lesion at any other site (48·4 versus 13·5 per cent; P < 0·001). In patients with lipomatous tumours at sites other than the lower limbs, MRI had a negative predictive value of 95 per cent for excluding ALT.
Despite concern, most deep lipomatous tumours (nearly 70 per cent) are benign lipomas. Certain features imply that tumours are almost never ALT: smaller than 5 cm or located outside the lower limb with no suspicious characteristics on MRI. Tumours with these features might safely and confidently be managed outside tertiary sarcoma centres.Full text
You may also be interested in
Short‐term medical treatment of hypercalcaemia in primary hyperparathyroidism predicts symptomatic response after parathyroidectomy.
Authors: A. Koman, S. Ohlsson, R. Bränström, Y. Pernow, R. Bränström, I.‐L. Nilsson et al.
Development and evaluation of the General Surgery Objective Structured Assessment of Technical Skill (GOSATS). BJS 2019; 106: 1617-1622.
Authors: Y. Halwani, A. K. Sachdeva, L. Satterthwaite, S. de Montbrun
Randomized controlled trial of plain English and visual abstracts for disseminating surgical research via social media. BJS 2019; 106: 1611-1616.
Authors: S. J. Chapman, R. C. Grossman, M. E. B. FitzPatrick, R. R. W. Brady
Authors: H. K. James, A. W. Chapman, G. T. R. Pattison, D. R. Griffin, J. D. Fisher
Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.
Authors: J. H. H. Olsen, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg
Effect of donor nephrectomy time during circulatory‐dead donor kidney retrieval on transplant graft failure.
Authors: L. Heylen, J. Pirenne, U. Samuel, I. Tieken, M. Coemans, M. Naesens et al.
Dysregulation of the actin scavenging system and inhibition of DNase activity following severe thermal injury.
Authors: R. J. Dinsdale, J. Hazeldine, K. Al Tarrah, P. Hampson, A. Devi, C. Ermogenous et al.
Authors: C. A. Sewalt, E. Venema, E. J. A. Wiegers, F. E. Lecky, S. C. E. Schuit, D. den Hartog et al.
Authors: A. M Lacy, R. Bravo, A. M. Otero‐Piñeiro, R. Pena, F. B. De Lacy, R. Menchaca et al.
Validation of the Norwegian survival prediction model in trauma (NORMIT) in Swedish trauma populations.
Authors: P. Ghorbani, T. Troëng, O. Brattström, K. G. Ringdal, T. Eken, A. Ekbom et al.
Human model of burn injury that quantifies the benefit of cooling as a first aid measure. BJS 2019; 106: 1472-1479.
Authors: E. H. Wright, M. Tyler, B. Vojnovic, J. Pleat, A. Harris, D. Furniss et al.