Mosaic-pattern dedifferentiation in liposarcoma and chondrosarcoma: imaging features of an uncommon form of dedifferentiation

Kevin Taylor, Mark J. Kransdorf, Adam J. Schwartz, Mary I. O’Connor, Matthew A. Zarka

Research output: Contribution to journalArticle

Abstract

The term “dedifferentiation” was classically used in sarcoma pathology to refer to tumors in which a high-grade, undifferentiated sarcoma, or a high-grade sarcoma showing heterologous differentiation, arises from a pre-existing neoplasm of borderline or low-grade malignancy. The best recognized examples of this include dedifferentiated liposarcoma, arising from atypical lipomatous tumor/well-differentiated liposarcoma, and dedifferentiated chondrosarcoma, arising from grade 1 hyaline chondrosarcoma of bone. In the overwhelming majority of cases, this dedifferentiated, high-grade sarcoma presents as a macroscopically visible mass, adjacent to and clearly distinct from the pre-existing low-grade lesion. It is less well appreciated that dedifferentiation may also occur in a so-called “mosaic pattern,’ in which the high-grade component is intimately admixed with elements of the precursor lesion, forming only microscopically apparent foci. This mosaic or co-mingling pattern of dedifferentiation is also reflected in the MR imaging appearance. In contrast to the classic pattern of dedifferentiation in which there are two distinct juxtaposed masses with different signal intensities and enhancement patterns, such changes are not seen in mosaic dedifferentiation. The imaging features of this pattern of dedifferentiation have not been described. In this report we describe the imaging features of two patients with mosaic pattern dedifferentiation, one with liposarcoma and one with chondrosarcoma. In both cases the precursor lesion was correctly diagnosed by pre-biopsy imaging, but the presence of high-grade sarcoma was not recognized.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalSkeletal Radiology
DOIs
StateAccepted/In press - Jan 23 2018

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Liposarcoma
Chondrosarcoma
Sarcoma
Neoplasms
Hyalin
Pathology
Biopsy
Bone and Bones

Keywords

  • Chondrosarcoma
  • Co-mingling
  • Dedifferentiation
  • Liposarcoma
  • Mosaic
  • MR imaging
  • Neoplasm

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Mosaic-pattern dedifferentiation in liposarcoma and chondrosarcoma : imaging features of an uncommon form of dedifferentiation. / Taylor, Kevin; Kransdorf, Mark J.; Schwartz, Adam J.; O’Connor, Mary I.; Zarka, Matthew A.

In: Skeletal Radiology, 23.01.2018, p. 1-6.

Research output: Contribution to journalArticle

Taylor, Kevin ; Kransdorf, Mark J. ; Schwartz, Adam J. ; O’Connor, Mary I. ; Zarka, Matthew A. / Mosaic-pattern dedifferentiation in liposarcoma and chondrosarcoma : imaging features of an uncommon form of dedifferentiation. In: Skeletal Radiology. 2018 ; pp. 1-6.
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