Ewing's sarcoma of the humerus - MRI appearance
Biopsy proven ewing's sarcoma of humerus. On chemotherapy.
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There is fairly large, ill-defined mass lesion involving the upper metaphysis and upper, mid and lower diaphysis of the right humerus with a circumferential soft tissue components. The lesion causes moth-eaten bone destruction with cortical disruption of the involved humerus and shows heterogeneously hyperintense signal on the T2W, gradient, PD images and hypointense signal on T1W images. The involved humerus shows aggressive periosteal reaction with laminated appearance extending into the circumferential soft tissue mass. There is pathological fracture with bowing of proximal-middle 1/3rd of right humerus. The abnormal marrow signal of the lesion measures approximately 10 cm in T1W coronal images.
The periosteal reaction with circumferential soft tissue component is heterogeneously hyperintense on the T2W and STIR images and hypointense on the T1W images. It involves the muscles in circumferential pattern.
Biopsy proven Ewing's sarcoma of humerus.
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