Dear OCAD,
I need help with the diagnosis of this:
57yo F with soft tissue mass palpable near the basis of 5th metatarsal, since 3 months.
US: hypoechogenous solid mass, no Doppler inside, little bit of posterior wall enhancement. No calcification. There is something which could look like a punctum… But I’ve had experiences and have been scared of sarcoma in this region and such, so I did an MRI.
MRI: isoT1 (to muscle), hyperT2 and DP, in DP there are serpigineous vascular-like structures inside, but no blooming on GRE. There is diffuse homogenous enhancement, with a type III curves (rapid initial enhancement followed by a plateau phase). It’s touching superficially the fascia of the abductor of the 5th finger, but without any clear sign of invasion.
DP
T1FS and T2FS
GRE (FFE)
T1Fs post Gado
Dynamic T1 ROI1 and 2 (blue and orange) are inside the lesion (there was a technical issue, don’t take into account the drops to -80).
Does anyone have an idea what it is? Beside the fact that it would suggest something malignant because of the perfusion curve?
Thanks in advance,
David
