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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Alveolar Soft Part Sarcoma: Imaging Evaluation.

Letícia Dos Reis Morimoto1,2,3, Henrique Manoel Lederman1,2, Carla Renata Donato Macedo4

  • 1Department of Radiology, Pediatric Oncology Institute - GRAACC (IOP-GRAACC), São Paulo, Brazil.

Seminars in Musculoskeletal Radiology
|March 31, 2025
PubMed
Summary
This summary is machine-generated.

A rare soft tissue sarcoma, Alveolar soft part sarcoma (ASPS), caused a thigh fracture in a teen. MRI revealed characteristic imaging findings, aiding diagnosis of this slow-growing cancer.

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Area of Science:

  • Oncology
  • Radiology
  • Orthopedic Surgery

Background:

  • Soft tissue sarcomas are rare malignancies, frequently affecting extremities, with suspicious features including large size, deep location, heterogeneous enhancement, and progressive growth.
  • Alveolar soft part sarcoma (ASPS) is a rare subtype, predominantly seen in children and young adults, typically affecting deep lower limb tissues with an indolent clinical course.

Purpose of the Study:

  • To report a case of pathologic transtrochanteric femur fracture secondary to Alveolar soft part sarcoma (ASPS) in a 16-year-old male.
  • To highlight key magnetic resonance imaging (MRI) findings indicative of ASPS, including intense enhancement, vascularization, and characteristic flow voids.

Main Methods:

  • Case report of a 16-year-old male presenting with thigh pain after soccer.
  • Imaging studies including MRI to evaluate a pathologic fracture and associated intramuscular lesion.
  • Analysis of imaging features such as lesion enhancement, vascularity, and flow voids.

Main Results:

  • Imaging revealed a pathologic transtrochanteric fracture of the right femur with a large, expansive intramuscular lesion in the adductor musculature.
  • The lesion demonstrated intense enhancement and vascularization with peripheral and central flow voids, characteristic of ASPS.
  • MRI, particularly with advanced techniques like diffusion-weighted imaging (DWI), proved crucial for diagnosis and characterization.

Conclusions:

  • Alveolar soft part sarcoma (ASPS) can present with a pathologic fracture, necessitating thorough imaging evaluation.
  • Specific MRI findings, including flow voids, are highly suggestive of ASPS, aiding in early diagnosis.
  • Advanced MRI techniques enhance diagnostic confidence for soft tissue sarcomas, including ASPS.