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 24-year-old male reports with left forefoot pain with enlarged soft tissue fullness at the base of the 2nd toe. History of excision of mass eight years prior. Left 2nd toe benign tumor removed.(QUIZ ANSWER) MOST LIKELY DIAGNOSIS:&#160;Giant cell tumor of the tendon sheath.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 bilobed soft tissue mass is centered along the plantar aspect of the midshaft of the proximal phalanx of the 2nd toe and surrounds a portion of the adjacent flexor digitorum longus tendon. This extends medially and dorsally measuring approximately 1.8 x 1.5cm in length and AP dimension respectively. The T1 signal intensity is just slightly hyperintense with the adjacent muscle and the T2 signal intensity is somewhat heterogeneous but also mildly hyperintense with the adjacent muscle. On the postcontrast images, there is vigorous and fairly homogeneous enhancement. The borders are somewhat ill defined. The adjacent osseous structures are unremarkable. No overt inflammation of the adjacent soft tissues is noted. Soft tissues elsewhere are unremarkable as are the osseous structures.&#160;CONCLUSION:&#160;Bilobed mass centered within the proximal phalanx of the 2nd toe and surrounding the flexor digitorum longus tendon and extending medially and dorsally. Based on the signal characteristics and enhancement pattern, a giant cell tumor of the tendon sheath over gout should be considered.</div>

Case

Regarding the mass in this case, which of the following diagnosis options is the most likely?