Presentation
Slow-onset progressive swelling of the right hypothenar eminence.
Patient Data
Age: 15 years
Gender: Female
From the case:
Rhabdomyosarcoma
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/91914/annotated_viewer_json?lang=us"}
- lobulated oval soft tissue mass surrounding the diaphysis of the fifth metacarpal at the palmar surface (hypothenar eminence).
- The mass shows high signal on fluid sensitive sequences with few millimetric cystic changes and multiple hypointense linear septa. It also shows avid heterogenous enhancement postcontrast administration.
- The mass causes scalloping with cortical loss of the palmar fifth metacarpal cortex at the mid diaphysis with marked bone marrow edema of the fifth metacarpal and adjacent soft tissue.
- The mass surrounds approximately 50% of the diameter of the proximal flexor digiti minimi tendon and completely encases the proximal extensor digiting minimi causing mild narrowing of the tendon.
Case Discussion
Mass lesions in the extremities have a wide differential. Radiographs are usually the first line investigation followed by MRI if there are aggressive features shown. Enhancing soft tissue masses on MRI indicates an aggressive pathology. The patient was referred to orthopedic surgery for resection. Histopathological analysis confirmed rhabdomyosarcoma.
Unable to process the form. Check for errors and try again.