Another youngster with an initially indeterminate soft tissue mass

This is a correlate to my synovial sarcoma case from last month. 32 year old with slowly growing mass at ulnar aspect of the wrist.

I read a non con wrist MR from an off site location yesterday. Here are some fluid sensitive and T1 images:

My friend was the orthopedist and she was scheduled for “excision of a ganglion” in a few days. I was able to have him talk the patient into coming back for contrast and diffusion (heterogeneous though relatively avid enhancement doesn’t show up well in these pictures).

Patient now headed to tertiary center for further workup and resection.

Thanks to Avneesh for sharing his talk on diffusion characterization of these lesions, gives me more to stand on when trying to modify protocols or get additional imaging at sites where we have less control!

Ben