Saturday quiz- ST-RADS- final answer

Hello,

This is a complicated case from Dr. Singer.

The answers were..

V- Ugly fella

V- Myxoid liposarcoma

IV- Intermediate gr liposarcoma

IV- chondroid Liposarcoma

IV- ALT with metaplastic calcifications

I myself woud have put it as IV rather than V- reasons being..

metaplastic calcified rounded dots (not necrotic calcification as we see in LPS or myxoid components)
solid component enhancing minimally- otherwise would go in V

The final diagnosis was chondoid lipoma, which is in ST-RADS III in the paper as taken from the WHO path classification

Dr. Monica Umpeirrez got to the closest diagnosis- she called it as chondroid LPS. Path was neg for MDM2

These can be incredibly difficult. I am glad no one called it ST-RADS II. Either f/up or biopsy is warranted, which is done for III-V.

At UTSW, we use these scoring systems (ST-RADS, OT-RADS, NS-RADS) routinely to help guide management rather than get into patology conundrum.

Best!
AC

Avneesh Chhabra, M.D. M.B.A.

Professor Radiology & Orthopedic Surgery

Chief, Division of Musculoskeletal Radiology

UT Southwestern Medical Center, Dallas, Tx

5373 Harry Hines Blvd.

Dallas, Tx-75390-9178

Office: 214-648-2122

avneesh.chhabra