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Lipoma
3%
42/1576
Synovial sarcoma
1%
15/1576
Undifferentiated pleomorphic sarcoma
10%
155/1576
Liposarcoma
85%
1343/1576
Hemangiopericytoma
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The history, radiographs, MRI, and histology images are consistent with a well differentiated low-grade liposarcoma. The radiograph shows a large soft tissue shadow in the thigh and the MRI scans show a heterogeneous soft tissue mass in the posterior compartment of the thigh with signal that is iso-intense and composed of significant stranding (arrows). The histology photo shows lipoblasts and a stroma of atypical neoplastic cells. The correct answer is not lipoma due to the presence of lipoblasts on histology and the concerning appearance of the MRI images. Synovial sarcoma, undifferentiated pleomorphic sarcoma, and hemangiopericytoma all look different on histology with the characteristic monphasic or biphasic apperance of synovial sarcoma and the endothelial forming blood vessels of the hemangiopericytoma. While the stromal neoplastic cells of undifferentiated pleomorphic sarcoma may look similar to liposarcoma, the lipoblasts make the distinction.
3.4
(19)
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