Correlation between radiological assessment and histopathological diagnosis in retroperitoneal tumors: Analysis of 291 consecutive patients at a tertiary reference sarcoma center

• Published in: European journal of surgical oncology 2014-12, Vol.40 (12), p.1662-1670
• Main Authors: Morosi, C, Stacchiotti, S, Marchianò, A, Bianchi, A, Radaelli, S, Sanfilippo, R, Colombo, C, Richardson, C, Collini, P, Barisella, M, Casali, P.G, Gronchi, A, Fiore, M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Angiomyolipoma - diagnostic imaging; Angiomyolipoma - pathology; Diagnosis; Female; Fibromatosis, Aggressive - diagnostic imaging; Fibromatosis, Aggressive - pathology; Gastrointestinal Stromal Tumors - diagnostic imaging; Gastrointestinal Stromal Tumors - pathology; Hematology, Oncology and Palliative Medicine; Humans; Leiomyosarcoma - diagnostic imaging; Leiomyosarcoma - pathology; Liposarcoma; Liposarcoma - diagnostic imaging; Liposarcoma - pathology; Male; Middle Aged; Myelolipoma - diagnostic imaging; Myelolipoma - pathology; Neurilemmoma - diagnostic imaging; Neurilemmoma - pathology; Predictive Value of Tests; Retroperitoneal Neoplasms - diagnostic imaging; Retroperitoneal Neoplasms - pathology; Retroperitoneal sarcoma; Retrospective Studies; Sensitivity and Specificity; Soft tissue sarcoma; Surgery; Tomography, X-Ray Computed
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2014.10.005

Abstract Objectives Aim of study was to assess the correlation between computed tomography scan (CT) findings and histopathology. Material and methods Data were collected on consecutive patients with suspected retroperitoneal sarcoma (RPS) referred to a tertiary sarcoma center. Patients underwent contrast enhanced multi-detector CT scans. Radiological features of lesions were classified according to the presence of a fatty (Group A) mass, or non-fatty (Group B) mass, both subdivided according to homogeneity and intralesional high-contrasted appearance. Radiological classification was compared with histopathological diagnosis. Sensitivity, specificity, positive/negative predictive value (PPV, NPV) were analyzed. Results Of 291 patients, 103/291 (35.4%) masses were classified in Group A and 188/291 (64.6%) in Group B. Diagnosis of mesenchymal tumor was obtained in 231/291 cases (79%) and non-mesenchymal tumor in 60/291 (21%). Sensitivity and specificity of Group A for liposarcoma were 76.7% and 92.0%; PPV and NPV were 86.4% and 85.6%. Sensitivity of Group B for a mesenchymal tumor was 55.4% and specificity was 0%; PPV and NPV were 68.1% and 0%. Conclusions None of radiological criteria were sufficient to anticipate a specific diagnosis, with the only exception of well differentiated liposarcoma and angiomyolipoma. In a series of suspected RPS, 21% of the lesions were finally non-mesenchymal tumors.