Affiliations 

  • 1 Taylor's University
  • 2 Hospital Queen Elizabeth
  • 3 Universiti Sains Malaysia
MyJurnal

Abstract

Introduction: In Malaysia, about 800 children are diagnosed with cancer, a globally a dreadful disease, each year, and osteosarcoma accounts for approximately 3% of such cancer. The early detection of the type and extent of bone cancer is important for effective management through surgery. But, the presence of soft tissue edema around a neoplasm can interfere with accurate local tumor staging and subsequent surgical planning. However very scanty research is done on this; none of the past studies focused specifically on the incidence and quantity of extraosseous edema and its impact. Our interdisciplinary retrospective study with objectives to study the presence of soft tissue edema adjacent to the tumors in the extremities, characterize their pattern and distribution involved 82 patients of wide range of age attending the Hospital Universiti Sains Malaysia with a histologically proven tumor or tumor-like lesion of bone. Methods: This paper emphasizes avoiding misinterpretation of such edema and subsequent over-staging of musculoskeletal tumor. We exclusively used 1T-Magnetic Resonance Imaging due to its excellent resolution. All cases were imaged (T1W, T2W, T1W fat suppressed Gadolinium enhanced, and STIR images) by using 1.5 Tesla MRI unit. STIR images permit study of larger volume of abnormal tissue than spin echo images. Results: Peritumoral edema in 5 cases, Paratumoral edema in 11 patients and mixed type in 45 cases were found including 10 benign tumors. Overall, 5 malignant lesions did not show any sift tissue edema! All the data were analyzed and interpretation and charecterisation of the edema was done by an experienced radiologist. The findings were correlated with histopathology examination results. Conclusion: In conclusion, accurate definition of the local extent of a bone tumor and exploration of soft tissue edema is required to maximize the success of diagnostic work-up and staging prior to biopsy and subsequent interventions while minimizing the amount of tissue removed.