EURORAD ESR

Case 14060

Neuritis ossificans, a very rare tumor.

Author(s)
Helena Mercedes Martinez Maicas
Isabel Elía Martínez.
Manuel Angulo Sánchez
Empar Mayordomo Aranda.
Cristina Ramírez Fuentes

Hospital Universitari i Politecnic La Fe; Av Fernando Abril Martorell 46026 Valencia ; Email:hmaicas@hotmail.com
 
Patient
male, 45 year(s)
 
 
  • Figure 1
    First RM study in his reference centre
     

    Coronal T1: Fusiform lesion adjacent to the right sciatic nerve.

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

    Coronal STIR: Marked hyperintensity of sciatic nerve and adjacent tissue by oedema.

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

    Axial T2

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

    Axial Fat saturation without contrast.

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

    Axial Fat saturation with contrast: Intense and homogeneous catchment of contrast by the lesion.

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

    Saggital T1: Well defined borders of the lesion known adjacent to the sciatic nerve.

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

    STIR showing marked reduction of the oedema.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Localisation; Special Focus: Oedema;

    T2: Welll defined borders. Adyacent haematoma in muscle belly of semitendinosis secondary to biopsia.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Localisation; Special Focus: Tissue characterisation;

    Saggital T2*: New appearance of cartographic calcification in the peripheral of the lesion.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    FAME without contrast

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

    FAMe with contrast: Homogeneous catchment of contrast less intense than in previous study.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Localisation; Special Focus: Neoplasia;
     
     
  • Figure 3
    Surgical resection and anatomopathological study
     

    Location of sciatic nerve, referenced with yellow thread in the pictured.

     
    Area of Interest: Extremities; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Microsurgical dissectión with complete excision of the lesión.

     
    Area of Interest: Extremities; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Input of neural branches to the osseus lesion adjacent to anterior face of sciatic nerve

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Anatomopathological study show a zonal differentiation with fibroblastic centre, osteoid formation zone and external ossification.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
Coronal T1: Fusiform lesion adjacent to the right sciatic nerve.
 
Coronal STIR: Marked hyperintensity of sciatic nerve and adjacent tissue by oedema.
 
Axial T2
 
Axial Fat saturation without contrast.
 
Axial Fat saturation with contrast: Intense and homogeneous catchment of contrast by the lesion.
 
Saggital T1: Well defined borders of the lesion known adjacent to the sciatic nerve.
 
STIR showing marked reduction of the oedema.
 
T2: Welll defined borders. Adyacent haematoma in muscle belly of semitendinosis secondary to biopsia.
 
Saggital T2*: New appearance of cartographic calcification in the peripheral of the lesion.
 
FAME without contrast
 
FAMe with contrast: Homogeneous catchment of contrast less intense than in previous study.
 
Location of sciatic nerve, referenced with yellow thread in the pictured.
 
Microsurgical dissectión with complete excision of the lesión.
 
Input of neural branches to the osseus lesion adjacent to anterior face of sciatic nerve
 
Anatomopathological study show a zonal differentiation with fibroblastic centre, osteoid formation zone and external ossification.
 
 
 
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