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. 2018 Oct;91(1090):20170579.
doi: 10.1259/bjr.20170579. Epub 2018 Jul 25.

Mesenchymal chondrosarcoma of the orbit: imaging features of CT and MRI

Mitsuteru Tsuchiya  1 , Takayuki Masui  1 , Yoshiro Otsuki  2 , Harumi Sakahara  3
Affiliations

Mesenchymal chondrosarcoma of the orbit: imaging features of CT and MRI

Mitsuteru Tsuchiya et al. Br J Radiol. 2018 Oct.

Abstract

Objective:: Mesenchymal chondrosarcoma (MCS) of the orbit is a rare and aggressive form of chondrosarcoma. The purpose of this study was to retrospectively identify the imaging features of mesenchymal chondrosarcoma of the orbit.

Methods:: This study included five patients with histologically confirmed MCS of the orbit who had undergone either CT, MRI, or both. Images were evaluated for the following: location, size, margin, CT density and presence or absence of calcification and/or ossification, MRI findings including dynamic contrast-enhancement and time-intensity curves.

Results:: CT was performed in four of the five patients, and all four (100%) demonstrated calcification and ossification of the mass. MRI was performed in all five patients. In two patients (40%), the mass demonstrated areas of hyperintensity on T1 weighted images.

Conclusion:: The presence of a well-defined, orbital mass with calcification and ossification on CT and, marked heterogenous enhancement and a rapid-washout pattern on dynamic MRI indicate a high probability of MCS of the orbit. In addition, MCS of the orbit can demonstrate areas of hyperintensity on T1 weighted images, representing bone marrow fat tissue of ossification.

Advances in knowledge:: MCS of the orbit is a highly malignant tumor, and early diagnosis by imaging is important. Radiologists should be aware of the imaging features of MCS of the orbit.

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Figures

Figure 1.
Figure 1.
Patient number 1. Mesenchymal chondrosarcoma of the right orbit in a 39-year-old female. She underwent initial orbital exenteration and was histologically diagnosed with mesenchymal chondrosaroma. This is the image when the tumor recurred 3 years after the initial orbital exenteration. (a) Axial CT demonstrated a soft tissue mass with calcification in the right orbit. (b) Axial T1WI showing an oval tumor with isointense-signal. (c) Coronal fat saturated T2WI showing that the tumor is low to isointense relative to the grey matter. (d) Diffusion-weighted image showing that the tumor is hyperintense. (e) Enhanced axial T1WI demonstrating a tumor with heterogeneous enhancement with intracranial infiltration. T1WI, T1 weighted image; T2WI, T2 weighted image.
Figure 2.
Figure 2.
Patient number 5. Mesenchymal chondrosarcoma of the left orbit in a 24-year-old male. (a) Axial CT image showing an oval isodense tumor with dense calcification. (b) Axial T1WI showing an oval tumor with an isointense-signal. (c) Axial T2 weighted image showing that the tumor is low to isointense relative to the grey matter. Coronal pre-contrast (d), and dynamic contrast-enhanced arterial phase (e) T1WI demonstrating marked and heterogeneous enhancement of the tumor. T1WI, T1 weighted image.
Figure 3.
Figure 3.
Patient number 3. Mesenchymal chondrosarcoma of the left orbit in an 18-year-old female. (a) Axial CT image showing an oval isodense tumor with ossification. (b) Axial T1WI demonstrating areas of hyperintensity within the tumor (arrow). (c) Axial T2WI showing hyperintensity in the tumor (arrow). (d) Axial fat-suppressed T2WI demonstrating that the tumor is low to isointense relative to the grey matter. Note that the fat signal that showed hyperintense on T2WI is saturated by fat-suppressed T2WI (arrow). (e) Post-contrast axial T1WI showing heterogeneous tumor enhancement. T1WI, T1 weighted image; T2WI, T2 weighted image.
Figure 4.
Figure 4.
Patient number 4. Mesenchymal chondrosarcoma of the right orbit in a 23-year-old male. (a) Axial CT image showing an oval isodense tumor with ossification. The fat attenuation is inside the ossification (arrow). (b) Coronal T1WI demonstrating areas of hyperintensity within the tumor (arrow). (c) Coronal IDEAL fat image demonstrating fat tissue within the tumor (arrow). Coronal pre-contrast (d), dynamic contrast-enhanced arterial Phase 1 (e), arterial Phase 2 (f), arterial Phase 3 (g), and delay (h) enhanced T1WI showing heterogeneous tumor enhancement. T1WI, T1 weighted image; T2WI, T2 weighted image.
Figure 5.
Figure 5.
Patient number 2. Mesenchymal chondrosarcoma of the right orbit in a 9-year-old girl. (a) Axial T1WI showing that an oval tumor in her right orbit is isointense compared to the grey matter. (b, c) Coronal and sagittal T2WI demonstrating that the tumor is low to isointense relative to the grey matter. Coronal pre-contrast (d), coronal dynamic contrast-enhanced arterial Phase 1 (e), and axial delay enhanced T1WI (f) showing heterogeneous enhancement. T1WI, T1 weighted image; T2WI, T2 weighted image.
Figure 6.
Figure 6.
The time intensity curves reveal rapid enhancement and early washout of contrast medium within the tumor. MCS, mesenchymal chondrosarcoma.
See this image and copyright information in PMC

References

    1. Lightenstein L, Bernstein D. Unusual benign and malignant chondroid tumors of bone. A survey of some mesenchymal cartilage tumors and malignant chondroblastic tumors, including a few multicentric ones, as well as many atypical benign chondroblastomas and chondromyxoid fibromas. Cancer 1959; 12: 1142–57. doi: 10.1002/1097-0142(195911/12)12:6<1142::AID-CNCR2820120610>3.0.CO;2-D - DOI - PubMed
    1. Dowling EA. Mesenchymal chondrosarcoma. J Bone Joint Surg Am 1964; 46: 747–54. doi: 10.2106/00004623-196446040-00004 - DOI - PubMed
    1. Yang BT, Wang YZ, Wang XY, Wang ZC. Mesenchymal chondrosarcoma of the orbit: CT and MRI findings. Clin Radiol 2012; 67: 346–51. doi: 10.1016/j.crad.2011.10.004 - DOI - PubMed
    1. Cárdenas-Ramírez L, Albores- Saavedra J, De Buen S. Mesenchymal chondrosarcoma of the orbit. Report of the first case in orbital location. Arch Ophthalmol 1971; 86: 410–3. doi: 10.1001/archopht.1971.01000010412009 - DOI - PubMed
    1. Bagchi M, Husain N, Goel MM, Agrawal PK, Bhatt S. Extraskeletal mesenchymal chondrosarcoma of the orbit. Cancer 1993; 72: 2224–6. doi: 10.1002/1097-0142(19931001)72:7<2224::AID-CNCR2820720726>3.0.CO;2-U - DOI - PubMed