EURORAD ESR

Case 14222

A case of an extremely calcified synovial Sarcoma

Author(s)
Joao Araujo, Carlos Macedo, Joao Oliveira, Joao Amorim, Joao Louro, Raquel Maia

rua Professor Rodolfo Abreu, N299, Hab C63 4150-637 Porto, Portugal; Email:joaoaraujo.rad@gmail.com
 
Patient
male, 48 year(s)
 
 
  • Figure 1
    X-Ray oblique, face and lateral
     

    Extremely calcified lesion projected in the plantar foot with no evidence of bone destruction.

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

    Extremely calcified lesion projected in the plantar foot with no evidence of bone destruction.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Bone scintigraphy

    Increased uptake of the radiotracer in the left foot.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Nuclear medicine conventional; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    Axial CT
     

    Soft tissue window revealed the extensively calcified soft-tissue mass

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

    Bone window scan revealed the extensively calcified soft-tissue mass. No bone erosion neather periosteal reaction were found.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Coronal CT

    Soft tissue window showing a huge lesion extensively calcified in the plantar face of the 1st to 4th metatarsal bone. Soft tissue component is also present.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 5
    MRI T1 SE

    Sagital T1 weighted image showing a heterogeneus mass in the plantar foot, with areas of low signal and areas with intensity similar, or slightly higher signal than the muscle.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 6
    MRI T2 SE

    Sagittal T2-weighted fat suppression image demonstrates the large heterogeneous soft-tissue mass with some areas with high signal.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 7
    T1 SE fat sat with contrast

    Post contrast axial image showing an heterogeneous captation mass in the plantar foot that are also evolving the 4th intermetatarsial space.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 8
    Biopsy guided by CT

    Biopsy of the calcified component of the lesion

     
    Area of Interest: Interventional non-vascular; Imaging Technique: CT; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
Extremely calcified lesion projected in the plantar foot with no evidence of bone destruction.
 
Extremely calcified lesion projected in the plantar foot with no evidence of bone destruction.
 
Increased uptake of the radiotracer in the left foot.
 
Soft tissue window revealed the extensively calcified soft-tissue mass
 
Bone window scan revealed the extensively calcified soft-tissue mass. No bone erosion neather periosteal reaction were found.
 
Soft tissue window showing a huge lesion extensively calcified in the plantar face of the 1st to 4th metatarsal bone. Soft tissue component is also present.
 
Sagital T1 weighted image showing a heterogeneus mass in the plantar foot, with areas of low signal and areas with intensity similar, or slightly higher signal than the muscle.
 
Sagittal T2-weighted fat suppression image demonstrates the large heterogeneous soft-tissue mass with some areas with high signal.
 
Post contrast axial image showing an heterogeneous captation mass in the plantar foot that are also evolving the 4th intermetatarsial space.
 
Biopsy of the calcified component of the lesion
 
 
 
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