Case Challenge

Stephen J Pomeranz

Gain confidence interpreting Soft Tissue Masses on MRI with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

X-Ray (Plain Films)

Case Review

Musculoskeletal (MSK)

Case 1 - 46-year-old female reports with lump in the distal shin

Case 2 - 43-year-old male presents with back and bilateral leg pain

Case 3 - 53-year-old male presents with history of shoulder pain

Case 4 - 63-year-old female reports with a history of otalgia

Case 5 - 48-year-old male is being evaluated for a soft-tissue mass

Case 6 - 61-year-old female reports with occasional discomfort at site of right shoulder mass

Case 7 - 65-year-old female reports with a history of giant cell tumor of tendon sheath

Case 8 - 15-year-old female is being evaluated for dorsal soft tissue mass

Case 9 - 63-year-old female reports with history of abnormal plantar soft tissue mass

Case 10 - 29-year-old female reports with left wrist discomfort

Case 11 - 57-year-old male presents with a history of fractured toe as a child

Case 12 - 42-year-old female reports with history of soft tissue mass

Case 13 - 69-year-old male presents with right knee pain and swelling

Case 14 - 72-year-old female presents with history of soft tissue mass, ganglion, thumb pain

Case 15 - 31-year-old male reports with with enlarging soft tissue mass

Case 16 - 40-year-old female presents with soft tissue mass distal forearm

Case 17 - 57-year-old male reports with history of deformity of bone

Case 18 - 48-year-old male reports with history of trauma in left finger

Case 19 - 60-year-old female presents with a soft tissue mass for 15 years

Case 20 - 55-year-old female presents with an anterior vaginal mass

Case 21 - 46-year-old female presents with salivary gland disorder

Case 22 - 35-year-old male presents with complaint of dorsal cyst

Case 23 - 69-year-old female reports with soft tissue mass of several months

Case 24 - 24-year-old male reports with left forefoot pain

Case 25 - 80-year-old male presents with right-sided liver mass

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 25 unique Soft Tissue Masses (STM) MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Soft Tissue Masses MRI Cases

<div>HISTORY:&#160;This 63-year-old female reports with history of otalgia.(QUIZ ANSWER) NOT A FINDING IN THIS CASE:&#160;Enlargement of Meckel's cave.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: A 4.5 x 2.3 x 2.5cm central and left soft tissue mass involving the left soft palate extending anteriorly to the level of the hard palate which appears to invade the left upper maxilla with maxillary and alveolar recess expansion and signal alteration. Soft tissue mass extends into the left pharyngeal mucosal space and base of the tongue with obstruction of the left eustachian tube resulting in marked left otomastoid airspace disease and eustachian tube fluid accumulation. Right otomastoid airspace disease.&#160;Small nodes within the parotids bilaterally.&#160;No adenopathy within the visualized portion of the jugular chain.&#160;No evidence of mandibular erosions.&#160;There is a soft tissue mass within the left parapharyngeal fat measuring 1.2cm which effaces the pharyngeal mucosal space medially, masticator space laterally and may represent a lymph node. Findings best appreciated on axial postcontrast series 16 image 8.&#160;No internal auditory canal or cerebellopontine angle masses.&#160;No extraaxial collections or hemorrhage.&#160;Multiple foci of parenchymal hyperintensity which may represent gliosis of microangiopathic origin.&#160;Nigral and pallidal iron stores are maintained.&#160;Diffusion weighted images are without a diffusion-restrictive defect.&#160;Calvarium is intact.&#160;Partial empty sella.&#160;Mucosal thickening within the left maxillary sinus.&#160;No enlargement of the cavernous sinuses or Meckel's caves.&#160;Carotid and basilar artery flow voids are intact.&#160;No evidence of leptomeningeal seeding.&#160;No obstructive hydrocephalus.&#160;CONCLUSION:&#160;Enhancing soft tissue mass within the left soft palate, hard palate, left base of the tongue, alveolar recess, and left maxilla extending into the left pharyngeal mucosal space contributing to eustachian tube obstruction. Bilateral otomastoid airspace disease left greater than right. The lesion effaces the left masticator space with an associated soft tissue mass within the left parapharyngeal fat which may represent adenopathy. Osseous signal within the left maxilla is abnormal with irregular osseous margins suggesting left maxillary infiltration and erosion. Differential may include squamous cell carcinoma, malignancy of minor salivary gland. Finding may correlate with provided history of otalgia.</div>

Case

Which of the following is NOT a finding in this case?