Finger tumour : high grade poorly differentiated sarcoma

Case contributed by Dr Maulik S Patel

Presentation

Left index finger nodule swelling - for about 6 mths. An attempt of local excision done about 2 - 3 mths back. Recurrence of larger lesion locally.

Patient Data

Age: 37 yrs
Gender: Male
Ultrasound

Previous Radiograph of hand ( No copy right ) - no bony changes.

There is Well-defined lesion involving middle phalanx soft tissue.

Location - It overlies middle phalanx, proximal - distal interphalangeal jointS, on volar side. Lesion extends to ulnar side. It is seperate from bone, tendon, joint.

Size                 - about 34 x 23 x 20 mm

Morphology - Lesion is hypoechoic / anechoic with echogenic multiple echogenic linear bands. There is no calcification. It shows lobulations. There is posterior acoustic enhancement present. Lesion is not significantly compressible.

Dopplar          - Significant Arterial is noted in the lesion. Digital artery is deep to proximal part of lesion. Digital artery passes through distal part of the lesion. 

Case Discussion

Surgical excision of tumour was done.

Immunohistochemistry suggested high grade poorly differenciated sarcoma ( Synovial or Ewings sarcoma / Primitive Neuroectodermal Tumor - PNET ). 

RT-PCR test - Ewings sarcoma.

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Case information

rID: 42030
Case created: 2nd Jan 2016
Last edited: 15th Feb 2017
Inclusion in quiz mode: Included

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