Presentation
Pain right hand with dorsal swelling. No trauma.
Patient Data
Multiple well-defined small lucencies / lytic areas are seen in the base of the fourth
metatarsal bone, the hamate bone, the capitate bone to lesser extent the base of the third metatarsal.
There is a lobulated hypoechoic lesion in the dorsum aspect of the right hand.
It is located adjacent to the extensor digitorum tendon and insinuates deep to the tendon and extends up to underlying carpometacarpal joint. On color vascularity noted.
An irregular lobulated ill-defined soft tissue mass is seen at the dorsal aspect of right wrist and hand. The mass is seen eroding the adjacent bones, namely: capitate, hamate and base of 3rd and 4th metacarpal bones. The mass is seen eliciting intermediate signal on T1 and T2 sequences and slightly bright signal on STIR WIs. It shows moderate enhancement at post contrast T1 WIs. It measures about 25x16x34 mm at its maximal CC, AP and T dimensions respectively. Furthermore, the lesion is seen compressing and inseparable from the overlying extensor tendons.
Case Discussion
The patient was referred to biopsy and the result was: Tenosynovial giant cell tumor