Keywords
Low-grade myofibroblastic sarcoma
Soft tissue tumor
Color Doppler flow imaging
Magnetic resonance imaging
Differential diagnosis
Submitted : 2026-04-19
Accepted : 2026-05-04
Published : 2026-05-19
Abstract
Objective: To analyze the ultrasonographic features of low-grade myofibroblastic sarcoma (LGMS) and explore its preoperative diagnostic value and key points of differential diagnosis. Methods: A case of LGMS confirmed by surgical pathology was retrospectively analyzed. The ultrasonographic manifestations were combined with magnetic resonance imaging (MRI) and pathological results for comprehensive analysis, and relevant literature was reviewed. Results: The patient was a 41-year-old female with a hypoechoic mass (45 mm × 30 mm × 21 mm) in the muscle layer of the left lower leg. The mass had an irregular shape with lobulated margins, and some boundaries were unclear. A large hyperechoic area (8.0 mm × 1.6 mm) was seen inside. Color Doppler flow imaging (CDFI) showed rich blood supply around and within the mass, and a cord-like extension was visible at the lower edge. MRI showed an isointense signal on T1-weighted images and a long T2 signal, with high signal intensity on diffusion-weighted imaging (DWI) and significant enhancement on contrast-enhanced scans. Postoperative pathology confirmed LGMS. Conclusion: The ultrasonographic manifestations of LGMS have certain characteristics, but a definite diagnosis still depends on pathological examination. Ultrasonography can provide important imaging evidence for preoperative assessment.
References
World Health Organization Classification of Tumours Editorial Board, 2020, WHO Classification of Tumours: Soft Tissue and Bone Tumours. Lyon: International Agency for Research on Cancer Press.
Gao G, Liu Y, Ao Y, et al., 2022, Low-Grade Myofibroblastic Sarcoma of the Proximal Femur: A Case Report and Literature Review. Medicine (Baltimore), 101(45): e31715.
Yonezawa H, Yamamoto N, Hayashi K, et al., 2020, Low-Grade Myofibroblastic Sarcoma of the Levator Scapulae Muscle: A Case Report and Literature Review. BMC Musculoskelet Disord, 21: 836.
Chen Z, Huang H, Chen X, 2012, Clinicopathological Analysis of 8 Cases of Low-Grade Myofibroblastic Sarcoma. Chinese Journal of Clinical and Experimental Pathology, 28(9): 987–990.
Zhang W, Xu Y, 2012, Imaging Manifestations of Low-Grade Myofibroblastic Sarcoma. Chinese Journal of Medical Imaging Technology, 28(8): 1591–1595.
Zhang X, Xu Y, Tang B, et al., 2014, Imaging Manifestations of Low-Grade Myofibroblastic Sarcoma and Inflammatory Myofibroblastic Tumor. Chinese Journal of Medical Imaging, 22(5): 358–360.
Gong L, Zhang L, Liu X, et al., 2009, Clinicopathological Observation of Low-Grade Myofibroblastic Sarcoma. Journal of Modern Oncology, 17(10): 1976–1978.
Qiu X, Sun B, Zhang L, et al., 2005, Clinicopathological Observation of 9 Cases of Low-Grade Myofibroblastic Sarcoma. Chinese Journal of Clinical Oncology, 32(10): 582–584 + 591.
Cai C, Dehner L, El-Mofty S, 2013, In Myofibroblastic Sarcomas of the Head and Neck, Mitotic Activity and Necrosis Define Grade: A Case Study and Literature Review. Virchows Arch, 463(6): 827–836.
Lin J, Zhang J, Hui J, et al., 2007, Inflammatory Myofibroblastic Tumor and Low-Grade Myofibroblastic Sarcoma. Chinese Journal of Clinical and Experimental Pathology, 23(4): 385–388.