|Title : Case 637|
Age / Sex : 48 / M
Chief complaint :
Left heel mass (1yr), construction worker
Clear Cell Sarcoma
Lateral radiograph of foot shows a hell mass at the heel with mild bone erosion of the calcaneal tuberosity
Non-contrast sagittal CT image of foot shows isodensity soft tissue mass of the heel and no internal calcification,
Sagittal T1- and fat saturated T2- weighted images reveal a large mass involving subcutaneous tissue and Achilles tendon. The mass has slightly higher signal intensity compared with foot muscle on T1 weighted images and intermediate to high signal intensity on T2 weighted images. Erosion with signal change of the adjacent calcaneal tuberosity is also seen.
Melanoma of soft part, but melanin is microscopic.
Young adult (20 to 40 yrs) with predilection for foot and ankle (43% of cases).
Theoretic effects of melanin (slightly increased signal intensity on T1-weighted images compared with muscle and low signal on T2-weighted images) can be shown, but not prominent because of the minute amount of melanin.
|Total applicants||22||Correct answers||3|
|윤유성||순천향대 부천병원, 전문의|
|Total applicants||22||Semi-Correct answers||5|