Imaging Presentation of Malignant Peripheral Nerve Sheath Tumor at Sacral Region

A 21-year-old male patient presented with the symptoms of weakness in both legs, urine and stool incontinence for several months. Neurological examination revealed flaccid bilateral leg. Sonography showed heterogeneously echogenic multilobulated soft-tissue mass with several cystic spaces within it. Magnetic resonance imaging showed iso-signal intensity soft-tissue mass in T1 weighted imaging with many high-signal intensity cystic areas. After intravenous administration of gadolinium contrast agent, the tumor showed moderate contrast enhancement. The most common sarcomatous lesions with cystic degeneration include chondroid tumor (such as chondrosarcoma), liposarcoma, synovial sarcoma, and malignant peripheral nerve sheath tumors. Tumor biopsy showed malignant peripheral nerve sheath tumor. The patient received arterial embolization, radiotherapy, and regular chemotherapy after the diagnostic workup.