Presentation
Painless swelling of the right forefoot since birth
Patient Data
There is a soft tissue mass centered on the 2nd digit with extension to the adjacent interdigital spaces. No foci of calcification seen within the mass. No bone lesion or periosteal reaction is seen.
The color Doppler images show a highly vascularized heterogeneous soft tissue mass centered on the 3rd digit.
The MRI sequences demonstrate an ill-defined lobulated soft tissue mass centered on the 3rd digit. It appears isointense to the muscles on T1WI, high signal on T2WI, containing phleboliths of low signal on T2 fat sat and GRE. The postcontrast sequences show a progressive and heterogeneous enhancement. There is encasement of the 3rd digit from the metatarsal head to the distal phalanx as well as the proximal phalanx of the 2nd digit with extension to the adjacent interdigital spaces, dorsal and plantar aspect of the forefoot as well as inter-and intramuscular extension (adductor hallucis muscle, tendons of the extensor/flexor digitorum of the 2nd and 3rd digits).
Case Discussion
Ultrasound and MRI features characteristic of a soft tissue hemangioma of the forefoot.