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Giant cell tumor of the tendon sheath

Case contributed by Dalia Ibrahim
Diagnosis probable

Presentation

Swelling at the right ring finger.

Patient Data

Age: 45 years old
Gender: Male

Well defined lobulated soft tissue lesion is abutting the ventrolateral aspect of the flexor tendon sheaths of the ring finger opposite the proximal interphalangeal joint causing focal contour bulge.

It elicits persistent low signal at all pulse sequences. 

Case Discussion

It is also known as pigmented villonodular tumor of the tendon sheath (PVNTS) or extra-articular pigmented villonodular tumor of the tendon sheath.

MRI

Not surprisingly, given the histological similarity to PVNS, giant cell tumors of the tendon sheaths also share the same finding on MRI, mainly on account of hemosiderin accumulation.

Signal characteristics include

  • T1 -
    • low signal
    • variable enhancement
  • T2 - low signal

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