Beckhorn Catherine,  Lee Rachel,  Cao Joseph

Final Pr. ID: Poster #: CR-028

Background: Granular cell tumors (GCT) are rare Schwann cell-derived soft tissue tumors typically presenting as a solitary, painless nodule in adults in the 4th to 6th decades of life, rarely presenting in children. GCT most commonly originate from gastrointestinal mucosa of the tongue or oral cavity, and are 2-3 times more common in women. While generally benign, approximately 2% of cases may be malignant; therefore, GCTs are typically treated with local surgical control.
Case: A 7-year-old male with sickle cell trait presented to clinic for a painless “pea-sized lump” on his penile shaft, which had been present since infancy but had recently grown larger. Ultrasound demonstrated a 1.8 cm lenticular-shaped mass on the dorsal mid shaft of the penis superficial to the fascial borders of the cavernous cavernosum. There was mild internal vascularity, but no invasion past fascial borders, surrounding soft tissue changes. On MRI, the mass was uniformly T1 iso-intense and T2 slightly hyperintense, with slight postcontrast enhancement. The mass was well-circumscribed, wrapped around the corpus cavernosum without invasion of the tunica albuginea, and exhibited uniform restricted diffusion, calcification, or internal fat. No lymph node involvement was noted on imaging. Surgical resection 8 months later noted a 3 cm mass, which now extended into the glans, with pathology consistent with benign GCT, with positive staining for S-100, CD68, SOX10, and calretinin, Ki-67 of 1%, and negative for SM actin. Due to depth of glans penetration, R2 resection was achieved based on the pediatric urologist’s decision to spare the glans, rather than performing a more aggressive distal penectomy. Post-operative MRI 4 months later demonstrated residual tumor with interval reduction in mass size. Additional investigation of the patient’s past medical history revealed that a benign GCT had been removed from the inside of his lip the previous year which helped support the final histopathologic diagnosis. While multifocal GCTs have been described in genetic syndromes, this patient had not undergone genetic testing to date. Read More

Authors:  Beckhorn Catherine , Lee Rachel , Cao Joseph

Keywords:  MRI, Genitourinary, Soft-Tissue Tumors

Chitalkar Sachin,  Shet Narendra

Final Pr. ID: Poster #: EDU-055

To review the characteristic imaging findings of pediatric fibroblastic/myofibroblastic masses to aid in their diagnosis and management.
Soft tissue lesions in pediatric patients encompass a wide variety of pathologies. While a comprehensive review of all possible pathologies is beyond the scope of this poster, we aim to review one particular subset of lesions, fibroblastic lesions (including myofibroblastic neoplasms), in hopes to bring these to mind when evaluating a pediatric soft tissue mass to improve diagnosis and management of these entities.
Soft tissue masses typically present clinically on the basis of history and physical examination. US and MRI are used as first- and second-line imaging modalities, with limited roles for radiographs, CT and FDG-PET. In this poster, we will review the pertinent imaging findings of these neoplasms. Read More

Authors:  Chitalkar Sachin , Shet Narendra

Keywords:  Soft Tissue Mass, Soft-Tissue Tumors, Pediatric Radiology

Hameed Shema,  Lloyd Claire,  Carmichael James,  Navarro Oscar

Final Pr. ID: Poster #: EDU-029

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. Read More

Authors:  Hameed Shema , Lloyd Claire , Carmichael James , Navarro Oscar

Keywords:  Soft-tissue tumors, Ultrasound, World Health Organization