Bone and Soft-Tissue Disorders
= borderline tumor with benign / locally aggressive / malignant behavior (counterpart of glomus tumor)
◊Clinical behavior + histopathologic features are similar to solitary fibrous tumor
Age: 4th5th decade; M÷F = 1÷1
Path: large vessels predominantly in tumor periphery
Histo: cells packed around vascular channels containing cystic + necrotic areas closely resembling cellular areas of solitary fibrous tumor; arising from contractile cells that surround the walls of vessels (= Zimmermann pericytes)
May be associated with: hypoglycemia (← overproduction of insulinlike growth factor), arthralgia, osteoarthropathy, digital clubbing
- slow-growing mass ± local mass effect
MR:
- well-circumscribed solid mass
- low to intermediate SI on T1WI + T2WI
- heterogeneously high SI on T2WI ← myxoid / cystic degeneration
- low signal-intensity rim around lesion (= pseudocapsule) on T2WI
- Soft tissue
= deep-seated well-circumscribed lesion arising in muscle
Location: lower extremity in 35% (thigh), pelvic cavity, retroperitoneum, head & neck (unlikely), meninges
- painless slowly growing mass up to 20 cm
- large lobulated well-circumscribed hypervascular mass
- foci of calcification + areas of necrosis
- displacement of kidney
- Breast (extremely rare)
- Bone (rare)
Location: lower extremity, vertebrae, pelvis, skull (dura similar to meningioma)
- osteolytic lesion in metaphysis of long / flat bone
- subperiosteal large blowout lesion (similar to aneurysmal bone cyst)
Angio:
- displacement of main artery
- pedicle of tumor feeder arteries
- spider-shaped arrangement of vessels encircling tumor
- small corkscrew arteries
- dense tumor stain
Prognosis: 4786% 10-year survival rate
DDx: hemangioendothelioma, angiosarcoma