Fascial tail sign

Last revised by Francis Deng on 20 Feb 2020

Citation, DOI, disclosures and article data

Citation:

Khader.O.Thabet M, Deng F, Bell D, et al. Fascial tail sign. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-44357

DOI:

https://doi.org/10.53347/rID-44357

Permalink:

https://radiopaedia.org/articles/44357

rID:

44357

Article created:

19 Apr 2016, Mohammed Al Khader.O.Thabet

Disclosures:

At the time the article was created Mohammed Al Khader.O.Thabet had no recorded disclosures.

View Mohammed Al Khader.O.Thabet's current disclosures

Last revised:

20 Feb 2020, Francis Deng ◉

Disclosures:

At the time the article was last revised Francis Deng had no recorded disclosures.

View Francis Deng's current disclosures

Revisions:

11 times, by 6 contributors - see full revision history and disclosures

Systems:

Gastrointestinal, Musculoskeletal

Sections:

Signs

Tags:

cases

Synonyms:

Tail sign (soft tissue tumor)
Tail sign of fascia

The fascial tail sign refers to the linear/tapered extension of soft tissue tumors along the fascia.

The sign has been classically described in benign fibrous proliferations ^1-4:

However, the same sign has also been described as the tail sign in soft tissue sarcomas that may arise in the fascia, with the highest frequency in the following ^5-13:

Thus, the diagnostic value of the sign in distinguishing between soft tissue tumors appears marginal. However, its recognition as tumoral infiltration rather than reactive fascial change is important in surgical planning to ensure complete resection given the risk of recurrence ^6-10.

Radiographic features

MRI

The fascial tail appears as a tapering marginal extension(s) of the tumor along the fascial plane. The tail enhances after administration of contrast media. The signal characteristics depend on the tumor (for example, T2 hypointense in the case of desmoid tumor but hyperintense in the case of myxofibrosarcoma).

References

1. Murphey MD, Ruble CM, Tyszko SM et-al. From the archives of the AFIP: musculoskeletal fibromatoses: radiologic-pathologic correlation. Radiographics. 2009;29 (7): 2143-73. Radiographics (full text) - doi:10.1148/rg.297095138 - Pubmed citation
2. Beaman FD, Kransdorf MJ, Andrews TR, Murphey MD, Arcara LK, Keeling JH. Superficial soft-tissue masses: analysis, diagnosis, and differential considerations. (2007) Radiographics : a review publication of the Radiological Society of North America, Inc. 27 (2): 509-23. doi:10.1148/rg.272065082 - Pubmed
3. Walker EA, Petscavage JM, Brian PL, Logie CI, Montini KM, Murphey MD. Imaging features of superficial and deep fibromatoses in the adult population. (2012) Sarcoma. 2012: 215810. doi:10.1155/2012/215810 - Pubmed
4. Walker EA, Fenton ME, Salesky JS et-al. Magnetic resonance imaging of benign soft tissue neoplasms in adults. Radiol. Clin. North Am. 2011;49 (6): 1197-217, vi. doi:10.1016/j.rcl.2011.07.007 - Pubmed citation
5. Lefkowitz RA, Landa J, Hwang S, Zabor EC, Moskowitz CS, Agaram NP, Panicek DM. Myxofibrosarcoma: prevalence and diagnostic value of the "tail sign" on magnetic resonance imaging. (2013) Skeletal radiology. 42 (6): 809-18. doi:10.1007/s00256-012-1563-6 - Pubmed
6. Yoo HJ, Hong SH, Kang Y, Choi JY, Moon KC, Kim HS, Han I, Yi M, Kang HS. MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign; diagnostic and prognostic value. (2014) European radiology. 24 (8): 1749-57. doi:10.1007/s00330-014-3181-2 - Pubmed
7. Imanishi J, Slavin J, Pianta M, Jackett L, Ngan SY, Tanaka T, Charoenlap C, DI Bella C, Choong PF. Tail of Superficial Myxofibrosarcoma and Undifferentiated Pleomorphic Sarcoma After Preoperative Radiotherapy. (2016) Anticancer research. 36 (5): 2339-44. Pubmed
8. Alpert JS, Boland P, Hameed M, Panicek DM. Undifferentiated pleomorphic sarcoma: indolent, tail-like recurrence of a high-grade tumor. (2018) Skeletal radiology. 47 (1): 141-144. doi:10.1007/s00256-017-2778-3 - Pubmed
9. De La Hoz Polo M, Dick E, Bhumbra R, Pollock R, Sandhu R, Saifuddin A. Surgical considerations when reporting MRI studies of soft tissue sarcoma of the limbs. (2017) Skeletal radiology. 46 (12): 1667-1678. doi:10.1007/s00256-017-2745-z - Pubmed
10. Song B, Lee K, Lee C, Moon KC. Prognostic significance of microscopic tumor extension in local recurrence of myxofibrosarcoma and undifferentiated pleomorphic sarcoma. (2018) Pathology international. 68 (9): 509-516. doi:10.1111/pin.12709 - Pubmed
11. Kaya M, Wada T, Nagoya S, Sasaki M, Matsumura T, Yamaguchi T, Hasegawa T, Yamashita T. MRI and histological evaluation of the infiltrative growth pattern of myxofibrosarcoma. (2008) Skeletal radiology. 37 (12): 1085-90. doi:10.1007/s00256-008-0542-4 - Pubmed
12. Crombé A, Marcellin PJ, Buy X, Stoeckle E, Brouste V, Italiano A, Le Loarer F, Kind M. Soft-Tissue Sarcomas: Assessment of MRI Features Correlating with Histologic Grade and Patient Outcome. (2019) Radiology. 291 (3): 710-721. doi:10.1148/radiol.2019181659 - Pubmed
13. Morii T, Tajima T, Honya K, Aoyagi T, Ichimura S. Clinical significance of the tail-like pattern in soft-tissue sarcomas on magnetic resonance imaging. (2018) Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association. 23 (6): 1032-1037. doi:10.1016/j.jos.2018.06.010 - Pubmed