Tenosynovial giant cell tumor
Right thumb pinless swelling for years.
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A dumbell-shaped soft tissue lesion is seen insinuating itself inbetween the flexor policies longus tendon and the plantar aspect of the proximal phalanx of the thumb with a lobulated smooth surface.
It shows homogeneous low signal intensity on T1W and T2W sequences with homogeneous post-contrast enhancement. It is outlined by a smooth thin hypointense rim.
It shows smooth scalloping of the plantar surface of the proximal phalanx of the thumb with intact cortex and stretches the flexor policies longus tendon.
The patient has a volar thumb swelling for years. The appearances of this peritendinous mass on the thumb finger are most consistent with a tenosynovial giant cell tumor (AKA giant cell tumor of the tendon sheath). It is a benign lesion that arises from the tendon sheath, slowly growing and can cause scalloping of adjacent bone. It is most commonly occurs on hand.