Presentation
Slowly enlarging, non-tender lump in the right foot
Patient Data
A well-defined soft tissue lesion was seen in the anteromedial aspect of the mid-foot deep to the tibialis anterior tendon; it measures 35 mm x 22 mm in size. The mass has a heterogeneous intermediate signal on T1 WI, a low signal on T2 WI, and a FAT SAT sequence with bright internal cystic changes. Some high T1 signal content likely represents blood or protein rather than fat, as it is not suppressed by fat saturation. No remodeling in the underlying bone cortex, marrow signal change, or nearby joint extension can be seen. No clear involvement of regional muscles and tendons. It has no relation to vascular structures. The immature bony skeleton within the scan appears unremarkable.
Histopathology examination results confirm benign neurofibroma of the dorsum of the foot.
Case Discussion
This case elicits one of the presentation and signal characteristics of a benign fibrous lesion owing to the predominant T2 low signal relative to skeletal muscle.
Pathologically proven peripheral nerve sheath tumor, neurofibroma, with complete surgical resection.
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