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Mesenchymoma (benign)

DEFINITION AND PATHOGENESIS

  • Benign neoplasm in which there are two or more types of cells of mesenchymal origin (not including fibrous tissue)

IMPORTANCE

  • Recognition of the benign nature of the lesion to avoid overtreatment
  • Mass ? pain

CLINICAL FEATURES

  • Mass ? pain

RADIOLOGIC FEATURES

  • ? calcification if cartilage is present, suggesting a soft tissue chondrosarcoma
  • ? fat demonstrated on CT or MRI (on T1 and STIR images)

GROSS PATHOLOGY

  • Prominent pseudocapsule
  • Hard mass
  • Cut surface is glistening white when cartilage is present, ? interspersed fat

HISTOLOGIC FEATURES

  • Chondrolipoangioma
  • Hypercellular cartilage in focal areas
  • Endochondral ossification in areas
  • Areas of mature fat and blood vessels

DIFFERENTIAL CLINICOPATHOLOGIC DIAGNOSIS

  • Soft tissue sarcoma
  • Malignant mesenchymoma

DISEASE COURSE AND TREATMENT

  • Excisional bx with minimal margins is adequate

SPECIAL CONSIDERATION

  • CHONDROLIPOANGIOMA
    • Contains cartilage, blood vessels, and fat

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