J Korean Soc Radiol.  2020 Jan;81(1):237-242. 10.3348/jksr.2020.81.1.237.

Ultrasound and MRI Findings of Giant Cell Fibroblastoma in the Abdominal Wall: Radiologic-Pathologic Correlations

• Min S
• Park SY
• Seo J
• Koh SH
• Lee K

• KMID: 2469200
• DOI: http://doi.org/10.3348/jksr.2020.81.1.237

Abstract

Giant cell fibroblastoma (GCF) is a rare soft-tissue sarcoma of fibroblastic origin. To the best of our knowledge, only one brief description of the MRI findings of GCF exists in the pathologic literature. Herein, we report a case of histologically proven GCF in a 3-year-old boy who underwent ultrasonography and MRI of a superficial mass in the abdominal wall.

MeSH Terms

Abdominal Wall*
Child, Preschool
Dermatofibrosarcoma*
Fibroblasts
Giant Cells*
Humans
Magnetic Resonance Imaging*
Male
Pathology
Sarcoma
Ultrasonography*

Figure

• 

  Fig. 1 A 3-year-old boy with giant cell fibroblastoma in the left lateral aspect of the lower abdominal wall. A. Grayscale ultrasonography shows a hypoechoic mass with well-demarcated margins in the subcutaneous fat layer of the left lower abdomen. Irregular septum-like echogenic structures are seen in the center of the mass. Doppler ultrasonography demonstrates prominent internal vascularity. B. The mass shows a slightly higher signal intensity compared to that of the skeletal muscle on the axial T2WI (upper left) and a more homogeneous, intermediate to low signal intensity compared to that of the muscle on the axial fat-saturated T1WI (upper middle). It shows different signal intensities at the center and periphery of the mass, with a central low and peripheral high signal intensity on the axial fat-saturated T2WI (upper right) and an intense peripheral enhancement on the fat-saturated T1-weighted contrast-enhanced image (lower left). Diffusion-weighted imaging (lower middle) using a b-value of 100 shows a high signal intensity of the mass, and on the ADC map (lower right), the calculated ADC value is 1.86 × 10−3 mm2s−1. ADC = apparent diffusion coefficient, T1WI = T1-weighted image, T2WI = T2-weighted image C. Photomicrographs show giant and spindle cells scattered throughout the mass and giant cells lining the slit-like pseudovascular spaces. The histologic composition is different at the center and periphery of the mass, with hypocellularity of giant and spindle cells and sclerosis, which implies abundant collagen, in the center of the mass, and abundant vascular channels with hypercellularity in the periphery of the mass (× 100; hematoxylin and eosin staining).

Reference

1. Baheti AD, O'Malley RB, Kim S, Keraliya AR, Tirumani SH, Ramaiya NH, et al. Soft-tissue sarcomas: an update for radiologists based on the revised 2013 World Health Organization classification. AJR Am J Roentgenol. 2016; 206:924–932.

2. Fletcher CD. The evolving classification of soft tissue tumours - an update based on the new 2013 WHO classification. Histopathology. 2014; 64:2–11.

3. Jha P, Moosavi C, Fanburg-Smith JC. Giant cell fibroblastoma: an update and addition of 86 new cases from the Armed Forces Institute of Pathology, in honor of Dr. Franz M. Enzinger. Ann Diagn Pathol. 2007; 11:81–88.

4. Maitra A, Timmons CF, Siddiqui MT, Saboorian MH. Fine-needle aspiration biopsy features in a case of giant cell fibroblastoma of the chest wall. Arch Pathol Lab Med. 2001; 125:1091–1094.

5. Shmookler BM, Enzinger FM, Weiss SW. Giant cell fibroblastoma. A juvenile form of dermatofibrosarcoma protuberans. Cancer. 1989; 64:2154–2161.

6. Fletcher CD, Bridge JA, Hogendoorn PC, Mertens F. WHO classification of tumours of soft tissue and bone. 4th ed. Geneva: World Health Organization;2013.

7. Terrier-Lacombe MJ, Guillou L, Maire G, Terrier P, Vince DR, De Saint Aubain Somerhausen N, et al. Dermatofibrosarcoma protuberans, giant cell fibroblastoma, and hybrid lesions in children: clinicopathologic comparative analysis of 28 cases with molecular data--a study from the French Federation of Cancer Centers Sarcoma Group. Am J Surg Pathol. 2003; 27:27–39.

8. Dinauer PA, Brixey CJ, Moncur JT, Fanburg-Smith JC, Murphey MD. Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics. 2007; 27:173–187.

9. Sundaram M, McGuire MH, Schajowicz F. Soft-tissue masses: histologic basis for decreased signal (short T2) on T2-weighted MR images. AJR Am J Roentgenol. 1987; 148:1247–1250.