Age / Sex : 55 / M

Chief complaint : soft tissue mass in anterior aspect of both lower legs (pre-tibial area) (onset; 1 yr)

Past hx; S/P thyroidectomy for Graves’ disease

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)

Courtesy : 이민희 (Min Hee Lee), 울산의대 서울아산병원 (University of Ulsan College of Medicine, Asan Medical Center)

pretibial myxedema (confirmed by US-guided biopsy)

Discussion

Findings
- focal areas of skin thickening, mild infiltrative change involving unyderlying subcutaneous fat layer in anterior aspects of both lower legs, showing T2 hypersignal with diffuse enhancement

References
FM, Vanhoenacker, MC Pelckmans, LH Beuckeleer et al. Thyroid acropachy: correlation of imaging and pathology. Eur Radiol 2001;11:1058-1062