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Paraffinoma in anterior abdominal wall mimicking liposarcoma

¹ Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin and ² Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Shatin, Hong Kong

Paraffinoma of breast is a recognized complication of paraffin injection for breast augmentation. Liquid paraffin can extend along fascial planes to involve adjacent tissues. A rare case of paraffinoma in anterior abdominal wall, which was misdiagnosed as a soft tissue liposarcoma before surgical excision, is reported. It was heterogeneous with marked posterior acoustic shadowing and small peripheral cysts on ultrasound. On MRI, it had ill-defined margins and was heterogeneous in signal intensity. Small round components which were hypointense on all sequences were demonstrated. There is significant overlapping of imaging features between paraffinoma and soft tissue liposarcoma. Histological differentiation from well-differentiated liposarcoma may also be difficult. A detailed clinical history of previous paraffin injection for breast augmentation is very important for correct interpretation of imaging and histopathological findings.