Bildgebende Diagnostik maligner Weichteiltumoren der Hand und des Unterarms

Maligne Weichteiltumoren an Hand und Unterarm sind selten. Neben der klinischen Untersuchung sind die Befunde der bildgebenden Diagnostik die Grundlage für die Therapieplanung. Die Magnetresonanztomografie (MRT) ist integraler Bestandteil des lokalen Tumorstagings und zusammen mit der Computertomografie (CT) auch der systemischen Tumordissemination. In diesem CME-Artikel werden die malignen Weichteiltumoren der Hand und des Unterarms bezüglich Pathoanatomie, Klassifikation und radiologischer Merkmale erläutert.

Schlüsselwörter

maligne Weichteiltumoren - Hand und Unterarm - bildgebende Diagnostik - Klassifikation - radiologische Merkmale

• Literatur

• 1 Grünert JG, Jakubietz MG, Jakubietz RG. Tumoren der Hand – Ergebnisse einer Langzeitstudie. Handchir Mikrochir Plast Chir 2004; 36: 289-295
• 2 Megerle K, Sauerbier M. Die Therapie von Weichteilsarkomen an Hand und Unterarm. Handchir Scan 2015; 4: 207-220
• 3 Tanaka K, Ozaki T. New TNM classification (AJCC eighth edition) of bone and soft tissue sarcomas: JCOG Bone and Soft Tissue Tumor Study Group. Jpn J Clin Oncol 2019; 49: 103-107
• 4 WHO. WHO Classification of Tumours. 5^th ed. Soft tissue and bone tumours. Lyon: IARC Press; 2020
• 5 Harper K, Sathiadoss P, Saifuddin A. et al. A review of imaging of surface sarcomas of bone. Skeletal Radiology 2021; 50: 9-28
• 6 Kallen ME, Hornick JL. The 2020 WHO classification: what's new in soft tissue tumor pathology?. Am J Surg Pathol 2021; 45: e1-e23
• 7 Gartner L, Pearce CJ, Saifuddin A. The role of the plain radiograph in the characterisation of soft tissue tumours. Skeletal Radiol 2009; 38: 549-558
• 8 Lodwick GS, Wilson AJ, Farrell C. et al. Determining growth rates of focal lesions of bone from radiographs. Radiology 1980; 134: 577-583
• 9 Benndorf M, Bamberg F, Jungmann PM. The Lodwick classification for grading growth rate of lytic bone tumors: a decision tree approach. Skeletal Radiol 2022; 51: 737-745
• 10 Carra BJ, Bui-Mansfield LT, O'Brien SD. et al. Sonography of musculo-skeletal soft-tissue masses: techniques, pearls, and pitfalls. Am J Roentgenol 2014; 202: 1281-1290
• 11 Upadhyay N, Saifuddin A. The radiographic and MRI features of gout referred as suspected soft tissue sarcoma: a review of the literature and findings from 27 cases. Skeletal Radiol 2015; 44: 467-476
• 12 Murphey MD, Gibson MS, Jennings BT. et al. From the archives of the AFIP: imaging of synovial sarcoma with radiologic-pathologic correlation. RadioGraphics 2006; 26: 1543-1565
• 13 Feydy A, Anract P, Tomeno B. et al. Assessment of vascular invasion by musculoskeletal tumors of the limbs: use of contrast-enhanced MR angiography. Radiology 2006; 238: 611-621
• 14 Holzapfel K, Regler J, Baum T. et al. Local staging of soft-tissue sarcoma: emphasis on assessment of neurovascular encasement-value of MR imaging in 174 confirmed cases. Radiology 2015; 275: 501-509
• 15 van Rijswijk CS, Geirnaerdt MJ, Hogendoorn PC. et al. Soft-tissue tumors: value of static and dynamic gadopentetate dimeglumine-enhanced MR imaging in prediction of malignancy. Radiology 2004; 233: 493-502
• 16 Verstraete KL, De Deene Y, Roels H. et al. Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging – parametric “first-pass” images depict tissue vascularization and perfusion. Radiology 1994; 192: 835-843
• 17 Einarsdóttir H, Karlsson M, Wejde J. et al. Diffusion-weighted MRI of soft tissue tumours. Eur Radiol 2004; 14: 959-963
• 18 Subhawong TK, Fishman EK, Swart JE. et al. Soft-tissue masses and masslike conditions: what does CT add to diagnosis and management?. Am J Roentgenol 2010; 194: 1559-1567
• 19 Kemp MA, Hinsley DE, Gwilym SE. et al. Functional and oncological outcome following marginal excision of well-differentiated forearm liposarcoma with nerve involvement. J Hand Surg Am 2011; 36: 94-100
• 20 Buecker PJ, Villafuerte JE, Hornicek FJ. et al. Improved survival for sarcomas of the wrist and hand. J Hand Surg Am 2006; 31: 452-455
• 21 Patel RR, Lupo PJ, Bishop AJ. et al. Synovial Sarcoma of the Hand and Foot: An Institutional Review. Am J Clin Oncol 2021; 44: 361-368
• 22 Yoo HJ, Hong SH, Kang Y. et al. MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign: diagnostic and prognostic value. Eur Radiol 2014; 24: 1749-1757
• 23 Vinnicombe SJ, Hall CM. Infantile fibrosarcoma: radiological and clinical features. Skeletal Radiol 1994; 23: 337-441
• 24 Nicholson S, Milner RH, Ragbir M. Soft Tissue Sarcoma of the Hand and Wrist: Epidemiology and Management Challenges. J Hand Microsurg 2018; 10: 86-92
• 25 De Beuckeleer LH, De Schepper AM, Vandevenne JE. et al. MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review. Skeletal Radiol 2000; 29: 187-195
• 26 Yun JS, Lee MH, Lee SM. et al. Peripheral nerve sheath tumor: differentiation of malignant from benign tumors with conventional and diffusion-weighted MRI. Eur Radiol 2021; 31: 1548-1557
• 27 Ammar A, Salon A, Moulonguet I. et al. MRI of squamous cell carcinoma of the nail apparatus: report of 6 cases. Skeletal Radiol 2023; 52: 613-622
• 28 Baek HJ, Lee SJ, Cho KH. et al. Subungual tumors: clinicopathologic correlation with US and MR imaging findings. RadioGraphics 2010; 30: 1621-1636
• 29 Anderson SE, Beer KT, Banic A. et al. MRI of merkel cell carcinoma: histologic correlation and review of the literature. Am J Roentgenol 2005; 185: 1441-1448
• 30 Rosenthal J, Cardona K, Sayyid SK. et al. Nodal metastases of soft tissue sarcomas: risk factors, imaging findings, and implications. Skeletal Radiol 2020; 49: 221-229
• 31 Lecouvet FE. Whole-body MR imaging: musculoskeletal applications. Radiology 2016; 279: 345-365