Presentation
Palpable painless nodule of the medial aspect of the right mid-thigh in a patient treated for Ewing sarcoma of the left iliac bone.
Patient Data
Poorly marginated subcutaneous nodule of the medial aspect of the right mid-thigh eliciting an isosignal to muscle on T1, high signal on T2 and STIR with restricted diffusion and vivid homogeneous enhancement on postcontrast sequences. Moderate infiltration of the surrounding fatty tissue with extension to the skin.
The initial MRI exam performed 18 months earlier demonstrates an osteolytic bone lesion centered on the left iliac wing with an enhancing soft tissue component invading probably the iliacus and gluteus muscles.
Case Discussion
MRI features of an enhancing cutaneous nodule in a patient treated for Ewing sarcoma of the left iliac bone.
The patient underwent complete surgical excision of the nodule with a histopathological exam that confirm the diagnosis of metastasis from Ewing sarcoma.
Cutaneous metastases from Ewing sarcoma are extremely uncommon 1,2.
On imaging, the main differential diagnosis includes soft tissue sarcomas and nodular fasciitis.
For more details, please refer to the article cutaneous and subcutaneous metastases.
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