Primary alveolar soft part sarcoma of the scapula

Abstract

Alveolar soft part sarcoma (ASPS) is an unusual soft tissue malignity, occurring in less than 1% of sarcomas and typically found in the head and neck tissues in children or, in adults, in the deep soft tissues of the lower extremities. In this report, we present a 33-year-old male with primary ASPS in the right scapular bone and discuss the radiologic features of this tumor in the context of the current literature.

Keywords: Alveolar soft part sarcoma; Lung metastasis; Scapula.

Fig. 1

Plain X-ray and CT findings. a X-ray examination because of right shoulder pain revealed a lytic scapular bone lesion with moth-eaten pattern. b Chest radiograph showed multiple nodular opacities due to bilateral lung metastasis. c Contrast-enhanced CT revealed a heterogeneous mass with intensive invasion to the scapula. d Bone window level CT revealed massive cortical destruction of the scapular bone.

Fig. 2

MRI of the right shoulder. a T1-weighted coronal image showed a large mass of moderately high signal with signal-void areas in the central portion. b Contrast-enhanced T1-weighted fat-suppressed coronal image revealed heterogeneous contrast enhancement of the lesion. c T2-weighted fat-suppressed axial image showed a hyperintense soft tissue mass with lobulated contour.

Fig. 3

Histological observation. a Large uniform tumor cells proliferated in an alveolar pattern (HE; 50×). b Cells with positive PAS reaction of the cytoplasm (PAS stain; 200×).