Purpose or Case Report: Soft-tissue tumors provide a significant part of a pediatric radiologists’ work. Using the World Health Organization (WHO) soft-tissue tumor classification system, those most relevant to pediatric imaging can be broadly categorized into tumors of adipocytic, fibroblastic/myofibroblastic, so-called fibrohistiocytic, vascular, nerve sheath, uncertain differentiation, smooth and skeletal muscle origin. Ultrasound remains the primary modality of choice as it is quick, provides excellent soft-tissue resolution, allows assessment of vascularity, is cost-effective and does not require sedation in young children. With rapidly advancing technology, exquisite soft-tissue detail can now be achieved, and along with additional knowledge of the natural history and imaging characteristics of soft-tissue tumors in recent years, the diagnostic accuracy of US has significantly increased.
The objectives of this exhibit are to review the sonographic imaging findings of benign and malignant pediatric soft-tissue tumors and present specific features that aid diagnosis using illustrative examples from our institutions.
Methods & Materials: The cases illustrated in this review are a collaboration from two internationally recognized children's hospitals. Prospective and retrospective cases imaged at our institutions have been collated utilizing our picture archive and communications system (PACS). This educational exhibit will present a pictorial review of a wide spectrum of lesions categorized according to the revised WHO 2013 classification system. History and pathophysiology of pediatric soft-tissue lesions will be presented alongside imaging findings in clinically and pathologically proven cases. Cases illustrated include granuloma annulare, myositis ossificans, fibrous hamartoma of infancy, fibromatosis and myofibromatosis, fibrosarcoma, congenital and infantile hemangiomas, kaposiform hemangioendothelioma, tufted angioma, vascular malformations, lipoma, lipoblastoma, benign and malignant peripheral nerve sheath tumors.
Results:
Conclusions: Pediatric soft-tissue tumors often present a diagnostic challenge. With advances in ultrasound, imaging now plays a pivotal role in the patient pathway and will often provide a diagnosis, guide further investigation or aid biopsy. We will review the specific sonographic features of a spectrum of pediatric soft-tissue tumors and guide the reader through proposed imaging algorithms.