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Semin Musculoskelet Radiol 2025; 29(02): 327-332
DOI: 10.1055/s-0045-1802354
Didactic Case Report

Alveolar Soft Part Sarcoma: Imaging Evaluation

Letícia dos Reis Morimoto 
1   Department of Radiology, Pediatric Oncology Institute - GRAACC (IOP-GRAACC), São Paulo, Brazil
2   Department of Radiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
3   Department of Musculoskeletal Radiology, Fleury Medicina e Saúde, São Paulo, Brazil
,
Henrique Manoel Lederman 
1   Department of Radiology, Pediatric Oncology Institute - GRAACC (IOP-GRAACC), São Paulo, Brazil
2   Department of Radiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
,
Carla Renata Donato Macedo 
4   Pediatric Oncology, Pediatric Oncology Institute - GRAACC (IOP-GRAACC), Federal University of São Paulo, São Paulo, Brazil
,
Denise Tokechi Amaral 
5   Department of Radiology, Hospital Sírio-Libanês, São Paulo, Brazil
,
Lucas de Figueiredo Barbosa 
6   Department of Pathology, Federal University of São Paulo, São Paulo, SP, Brazil
,
Júlio Brandão Guimarães 
1   Department of Radiology, Pediatric Oncology Institute - GRAACC (IOP-GRAACC), São Paulo, Brazil
2   Department of Radiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
3   Department of Musculoskeletal Radiology, Fleury Medicina e Saúde, São Paulo, Brazil
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Abstract

This case report concerns a 16-year-old boy who developed pain in his right thigh after a soccer game. Imaging studies revealed a pathologic transtrochanteric fracture of the right femur, accompanied by a large expansive intramuscular lesion centered in the deep planes of the adductor musculature. Main imaging findings included intense enhancement and vascularization of the lesion, along with peripheral and central flow voids, the latter described as characteristic of this subtype of soft tissue sarcoma. Alveolar soft part sarcoma is a rare and distinctive sarcoma with an indolent clinical course that typically occurs in young patients and predominantly affects the deep tissues of the lower limbs.

Key Points

  • Soft tissue sarcomas are a rare group of malignancies, often found in the extremities. Suspicious features include larger size, deeper location, heterogeneous enhancement, and progressive growth.

  • Alveolar soft part sarcoma (ASPS), a rare subtype primarily seen in children, is characterized by high T1 signal intensity, intense contrast enhancement, and more than five central and peripheral flow voids that are highly indicative of this condition.

  • Magnetic resonance imaging (MRI) is the preferred modality for evaluating these lesions. Advanced MRI techniques, such as diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), enhance diagnostic confidence, particularly in postoperative evaluations.

Keywords

alveolar soft part sarcoma - soft tissue sarcoma - magnetic resonance imaging


Publication History

Article published online:
31 March 2025

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