Spindle cell sarcomas are a rare and aggressive type of soft-tissue sarcoma. Although rhabdomyosarcomas are the most common childhood sarcoma, the spindle cell type is incredibly rare. A 25-year-old healthy G2P1001 female presents at 34 weeks gestational age with fetal growth restriction of a male fetus. Prenatal ultrasound showed a complex vascular mass exophytic to the distal spine, with a presumed diagnosis of sacrococcygeal teratoma (SCT). For further characterization, a fetal MRI was performed at 35 weeks gestation, which showed a solid appearing mass exophytic to the pelvis and involving the proximal thigh. Many features of the tumor were atypical for sacrococcygeal teratoma: the mass being more homogenous than expected, lacking cystic components that would normally been seen in a SCT, and involving the thigh but without definite involvement of the spine. It was also noted that the normal T1 meconium signal in the rectum was displaced posteriorly by the mass. At that time, an alternative differential diagnosis was suggested: sarcoma including fibrosarcoma or rhabdomyosarcoma, myofibroma, or less likely atypical sacrococcygeal teratoma. The baby was born via C-section at 37 weeks and 1 day gestation. A postnatal MRI showed the mass exophytic to the pelvis with some intrapelvic extension via the inguinal canal. Lack of spine involvement was confirmed. Signal characteristics of the tumor were similar to that of skeletal muscle, with a few focal areas of internal hemorrhage. The tumor had mass effect on multiple structures: deviating and tethering of the rectum to the right and stretching it inferiorly; displacing the anus posteriorly; uplifting the bladder; and abutting the base of the penis with no clear fat planes. Surgical resection was performed when the baby was 6 days old. Pathology evaluation revealed a sarcoma that was diffusely infiltrative with NTRK reactivity by immunohistochemistry. Molecular studies by next-generation sequencing reported TPM3-NTRK1 fusion in the tumor. Pathology was most suggestive of a spindle-cell sarcoma. It is important for the pediatric radiologist to be familiar with fetal soft tissue tumors to help facilitate family counseling and delivery planning. The radiologist should understand imaging features that may help distinguish more rare soft tissue tumors from sacrococcygeal teratomas. Although an exact diagnosis may not be possible prenatally, a multidisciplinary approach ensures the best possible patient outcomes. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Kazelka Maryam, Shao Lei, Mcgraw Marty, Neville Kucera Jennifer

Keywords: Sarcomas, Fetal Magnetic Resonance Imaging, Soft Tissue Sarcoma

Pediatric ovarian masses, though uncommon, represent an important subset of gynaecologic pathology in children and adolescents. This review aims to provide a comprehensive overview of the imaging features of pediatric ovarian masses. There are a myriad of pediatric ovarian lesions comprising benign and malignant masses as well as non-neoplastic lesions. While non-neoplastic lesions such as functional or hemorrhagic cysts, torsion, and tubo-ovarian abscesses predominate in incidence, germ cell and sex cord–stromal tumours account for the majority of ovarian malignancies in this age group. Early detection and characterization of these lesions using multimodal imaging techniques help in optimising management, avoiding unnecessary interventions and preserving future fertility in affected children. Read More

Meeting name: IPR 2026 Congress , 2026

Authors: Chaudhri Sukriti, Webb Kevin, Mcgraw Marty, Silva Gleidson, Kucera Jennifer

Keywords: Pediatric, Ovarian, Masses

Scrotal and paratesticular abnormalities in the pediatric population encompass a wide spectrum of conditions, ranging from benign congenital anomalies to rare but potentially aggressive neoplastic processes. Timely and accurate identification of these entities is critical for guiding appropriate clinical management, minimizing unnecessary surgical procedures, and ensuring prompt diagnosis of serious or life-threatening conditions. This pictorial review offers a thorough and visually rich overview of both frequently encountered and uncommon testicular and paratesticular lesions in children. Common findings such as hydrocele, varicocele, inguinal hernia, and epididymal cysts are presented alongside rare and unusual entities including supernumerary testis, scrotal plexiform neurofibroma, testicular adrenal rest tumors, epididymal cystadenoma, and rhabdomyosarcoma. The various types of spermatic cord hydroceles will also be shown. For each condition, characteristic imaging features are illustrated using multiple modalities—ultrasound, MRI, and CT—highlighting key diagnostic clues that aid in differentiating these lesions from mimics with similar clinical or radiologic presentations. By emphasizing the salient imaging findings and providing practical tips for interpretation, this educational exhibit aims to enhance radiologists’ awareness of rare pediatric scrotal pathologies, improve diagnostic confidence, and ultimately contribute to better-informed treatment decisions and optimized patient outcomes. Read More

Meeting name: IPR 2026 Congress , 2026

Authors: Silva Gleidson, Gupta Kanika, Mcgraw Marty, Koberlein George, Verhage Thomas, Kucera Jennifer

Keywords: Testicles, Testicular Tumor, Scrotum