EURORAD ESR

Case 10146

Fibroma of the tendon sheath

Author(s)
Kelemouridou Maria1, Reijnierse Monique2

1Aristotle University of Thessaloniki (A.U.Th.), Medical School, Radiology Department, Thessaloniki, Greece, Email:mkelemouridou@hotmail.com
2Department of Radiology, Leiden University Medical Center, The Netherlands
 
Patient
male, 62 year(s)
 
 
  • Figure 1
    MR
     

    Axial T1WTSE image of the wrist shows a lobulated mass in the carpal tunnel. The mass abuts tendons and is isointense to muscle with central bands of low signal. The median nerve is displaced.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T2WFS image shows the mass to have heterogeneous low to intermediate signal intensity.Areas of low signal are demonstrated. Hemosiderin deposition can only be excluded on gradient echo images which aren't...

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T1 FS+Gd image . Inhomogeneous enhancement of the tumor is appreciated which is continuous with circular enhancement around an ulnar sided flexor tendon.Persistent areas of low signal consistent with fibrous...

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    MR
     

    More proximal axial T1 weighted image after gadolinium administration shows a large area with only peripheral enhancement (see also fig 2c.)

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T2 weighted image at the same level depicts the aforementioned nonenhancing area, with high signal intensity, consistent with fluid.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Sagittal T1WI FS+Gd shows the extend of the well circumscribed lesion that depicts inhomogeneous enhancement with regions of persistent low signal. The nonenhancing part proximally shows high intensity on T2,...

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
Axial T1WTSE image of the wrist shows a lobulated mass in the carpal tunnel. The mass abuts tendons and is isointense to muscle with central bands of low signal. The median nerve is displaced.
 
Axial T2WFS image shows the mass to have heterogeneous low to intermediate signal intensity.Areas of low signal are demonstrated. Hemosiderin deposition can only be excluded on gradient echo images which aren't available.
 
Axial T1 FS+Gd image . Inhomogeneous enhancement of the tumor is appreciated which is continuous with circular enhancement around an ulnar sided flexor tendon.Persistent areas of low signal consistent with fibrous tissue.
 
More proximal axial T1 weighted image after gadolinium administration shows a large area with only peripheral enhancement (see also fig 2c.)
 
Axial T2 weighted image at the same level depicts the aforementioned nonenhancing area, with high signal intensity, consistent with fluid.
 
Sagittal T1WI FS+Gd shows the extend of the well circumscribed lesion that depicts inhomogeneous enhancement with regions of persistent low signal. The nonenhancing part proximally shows high intensity on T2, consistent with fluid.
 
 
 
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