Presentation
Palmar nodule for 5 years at the left hand's MCP joint/proximal phalanx region. Radiograph - not available.
Patient Data
Age: 40 years
Gender: Male
From the case:
Giant cell tumor of tendon sheath
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A well-defined ovoid lesion is seen in the region of interest at the level of the 4th metacarpophalangeal joint and proximal phalanx.
Size: 25 x 21 x 10 mm. Long axis of lesion is parallal to metacarpus.
Location: Superficial to the flexor tendon of the 4th digit. Lesion abuts and surrounds about 180 degrees of the flexor tendon.
Dynamic scan: shows free tendon movement from the lesion
Morphology:
- heterogeneously hypoechoic, solid, no calcification / cystic changes
- small lobulations present, no posterior acoustic enhancement
- not compressible
- Doppler flow predominantly in the wall of the lesion, central flow present
Case Discussion
On the basis of ultrasound findings and a history of slow growth, the possibility of a giant cell tumor of tendon sheath was suggested.
The lesion was excised.
Histopathology: giant cell tumor of tendon sheath
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