bims-myxlip 2025-11-02 papers

Issue of 2025–11–02
two papers selected by
Laura Mannarino, Humanitas Research

Front Cardiovasc Med. 2025 ;12 1685844

Case report and diagnostic implications of misdiagnosis of pericardial myxoid liposarcoma by multimodal imaging.

Juan Wang, Xi-Jun Zhu, Li-Xia Sun, Yu-Ling Song, Lai Wu, Yun-Long Cao, Xin-Yu Xue, Dong Wang, Qian Liu.

Myxoid liposarcoma (MLPS) typically occurs in the extremities. Pericardial involvement is exceptionally rare and usually indicates metastatic disease. Because of their non-specific imaging features, such lesions are often mistaken for benign tumors, leading to diagnostic errors. This report describes the case of a 69-year-old woman who presented with chest tightness and had a history of gluteal MLPS. Multimodal imaging (CT, ultrasound, MRI) revealed a pericardial mass. Although features such as well-circumscribed margins and delayed contrast filling suggested a benign-appearing lesion rather than enabling a definitive diagnosis, the clinical history of the patient strongly favored metastatic MLPS. Imaging alone could not provide a definitive diagnosis, highlighting the challenge posed by overlapping features between benign and malignant cardiac masses. The final diagnosis relied on histopathology and molecular testing. Postoperative immunohistochemistry revealed a spindle cell tumor with myxoid stroma (S-100 negative, MDM2 weakly positive). Molecular pathology confirmed the diagnosis by detecting the FUS-DDIT3 fusion gene, establishing metastatic MLPS. This case underscores the critical limitations of imaging in reaching a definitive diagnosis and emphasizes that accurate classification necessitates integration with histopathological and molecular analyses. An optimized diagnostic strategy should incorporate a comprehensive review of clinical history-especially any prior sarcoma-maintain heightened vigilance for overlapping imaging features of rare sarcomas in atypical locations, and include molecular pathology to effectively prevent misdiagnosis.

Keywords: CMR; cardiac mass; echocardiography; myxoid liposarcoma; pericardial tumor

DOI: https://doi.org/10.3389/fcvm.2025.1685844

Skeletal Radiol. 2025 Oct 31.

MRI-based radiomic analysis for grading myxoid liposarcoma: a multisequence retrospective study.

Silvia Ruggeri, Giuliana Roselli, Roberto Scanferla, Sebastiano Paolucci, Annarita Palomba, Daniela Greto, Mauro Loi, Francesco Muratori, Guido Scoccianti, Marco Bartolini, Linda Calistri, Lorenzo Livi, Domenico Andrea Campanacci, Vittorio Miele.

OBJECTIVES: This study aimed to identify quantitative MRI features through radiomic analysis and to develop predictive models for determining the histological grade of myxoid liposarcoma (MLS).
MATERIALS AND METHODS: This retrospective single-center study included 57 patients with histologically confirmed MLS (30 low-grade, 27 high-grade). Tumors were segmented and 107 radiomic features were extracted from T1-weighted imaging (WI), T2-WI, short tau inversion recovery (STIR), apparent diffusion coefficient (ADC) maps, and contrast-enhanced (CE) images with and without fat saturation (FS). Features showing statistical significance (p < 0.05) were selected and used to develop predictive models, whose performance was assessed using cross-validation and reported as area under the curve (AUC).
RESULTS: Mean age was 51.6 ± 14.7 years (32 men, 25 women). Radiomic analysis identified three significant features for T1-WI and STIR and 19 for T2-WI. For CE-T1-WI, CE-T1-FS-WI, and CE-3D, four, six, and three features were significant, respectively. Models based on T2-WI and CE-3D achieved the highest performance (AUC up to 0.88). Additional models trained exclusively on institutional T1-WI and T2-WI showed reduced performance on external validation, although AUCs improved when applied to patients scanned with the same vendor.
CONCLUSION: Radiomic analysis of pre-treatment MRI shows promising results in predicting histological grade of MLS. This study is novel in addressing grading rather than diagnosis alone, a distinction with clear clinical relevance for treatment planning and prognostic assessment. In particular, models based on T2-WI may complement conventional imaging and histopathology by providing whole-tumor quantitative grading, while multicentric validation is required for clinical application.

Keywords: Magnetic resonance imaging; Myxoid liposarcoma; Neoplasm grading; Radiomics; Soft tissue sarcoma

DOI: https://doi.org/10.1007/s00256-025-05069-z