ObjectiveTo analyze the ultrasonic manifestations of myxoid liposarcoma (MLS) in soft tissues.MethodsWe retrospectively analyzed the ultrasonic characteristics of 10 cases of soft tissue MLS which were pathologically confirmed between January and June 2006. Results Ultrasonic manifestations: 8 cases occurred in muscles and 2 in subcutaneous tissues and muscles; the maximum mass diameter was (71.1±39.4) mm; 10 cases had clear border, 8 had regular shape, and 9 had posterior echo enhancement; 10 cases were all solid masses with mucous liquid zone (9 cases had mainly weak echo, among which 5 had strong echo areas; 1 case had mainly strong echo); bloodstream grade: 3 cases belonged to level 0, 3 level Ⅰ, 2 level Ⅱ, and 2 level Ⅲ. Pathologic findings: 2 cases had low differentiation; 1 case was a mixture of MLS and atypical lipoma with mainly strong ultrasonic echo; the rest 7 cases had middle or high differentiation.ConclusionsUltrasonic manifestations of soft tissue MLS are mostly large masses in the muscular layer with clear border, regular shape, posterior echo enhancement and mucous liquid zone. Various degrees of strong echo zone exist in the masses. Bloodstream and mucous liquid zone are correlated with differentiation degree, and ultrasonic manifestations can be influenced if other factors exist.
Objective To compare the effectiveness of different treatment strategies after unplanned surgery for myxoid liposarcoma (MLS) and explore the clinical value of salvage therapy versus planned treatment following unplanned resection. Methods The clinical data of 37 MLS patients admitted between June 2014 and June 2024 who met the selection criteria were retrospectively analyzed. Patients were divided into three groups based on initial treatment status: the unplanned treatment group (group A, 14 cases, transferred after benign tumor excision without further treatment at external hospitals, presenting with local recurrence), the salvage planned treatment group (group B, 10 cases, transferred within 1 month after benign tumor excision at external hospitals), and the planned treatment group (group C, 13 cases, transferred without prior treatment or only after biopsy). No significant difference (P>0.05) was observed among the three groups in baseline characteristics including age, height, weight, and maximum preoperative tumor diameter. Tumor recurrence or metastasis time were recorded. Overall survival (OS) and disease-free survival (DFS) rates were calculated using the Kaplan-Meier method with intergroup comparisons. ResultsAll 37 patients were followed up 19-193 months (mean, 67.4 months). Group A exhibited higher tumor recurrence (28.6%) and metastasis rates (35.7%) than group B (10.0%, 10.0%) and group C (0, 23.1%), with significant differences in recurrence rates (P<0.05), no significant differences existed between groups B and C (P>0.05); metastasis rates showed no intergroup significance (P>0.05). Group A demonstrated lower 1-/3-/5-year DFS (71.4%, 42.9%, 21.4%) than group B (100%, 88.9%, 74.1%) and group C (92.3%, 83.9%, 71.9%), with significant differences (P<0.017), no significant difference existed between groups B and C (P>0.017); 3-/5-year OS showed no intergroup significance (P>0.05). Conclusion Patients with MLS should undergo standard extended resection and individualized adjuvant radiotherapy and chemotherapy as soon as possible after unplanned surgery to significantly reduce the local recurrence rate. In view of the high risk of extrapulmonary metastasis, a comprehensive preoperative assessment of metastasis is required.