대한근골격영상의학회

Title : Case 131

Age / Sex : 69 / F Age / Sex : 69/F Chief complaint : Rt. thigh palpable mass (1MA) 1) What is your impression? Two weeks later, you can see the final diagnosis with a brief discussion of this case. Send Application answers to Ja-Young Choi, MD ([email protected]). Courtesy: Jung-Ah Choi, MD., Seoul National University Bundang Hospital Diagnosis: proliferative myositis Discussion Findings: On initial MRI, About 2.7 x 2.5 x 5.2cm sized, T1 mild hyperintense and T2 hyperintense mass in vastus lateralis, with good enhancement On FU MRI, Focal area of subtle high signal intensity on T1 and T2WI with mild enhancement at vastus lateralis, right. - with linear low signal intensity at subcutaneous fat on T1 and T2WI. - site of mass on previous outside MRI. --> postop change, more likely. Differential Diagnosis: malignant soft tissue tumor, such as MFH, liposarcoma (possibly pleomorphic or myxoid type), leiomyosarcoma, synovial sarcoma. Diagnosis: Proliferative Myositis Discussion: Proliferative Myositis Pseudosarcomatous proliferative soft tissue lesion Common in Adults ( mean age 50 yrs ) Location : Head and neck , Upper Extremities Histolopathology : Infiltration with basophilic giant cells and proliferative fibroblast Clinical finding : rapidly enlarging solitary soft tissue mass, firm and painful Differentials : soft-tissue tumors (angiomatous lesions, lipoma, MFH, sarcomas), traumatic injury, myositis ossificans, muscle sarcoidosis, etc. Treatment : Local excision or Observation References: Radiology 2007 ; 244 : 613 - 616 Radiographics 2004 24 : 1477-1481

Title : Case 131

Age / Sex : 69 / F

Age / Sex : 69/F

Chief complaint : Rt. thigh palpable mass (1MA)

1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

Send Application answers to Ja-Young Choi, MD ([email protected]).

Courtesy: Jung-Ah Choi, MD., Seoul National University Bundang Hospital

Diagnosis:

proliferative myositis

Discussion

Findings:

On initial MRI,

About 2.7 x 2.5 x 5.2cm sized, T1 mild hyperintense and T2 hyperintense mass in vastus lateralis, with good enhancement

On FU MRI,

Focal area of subtle high signal intensity on T1 and T2WI with mild enhancement at vastus lateralis, right.

- with linear low signal intensity at subcutaneous fat on T1 and T2WI.

- site of mass on previous outside MRI.

--> postop change, more likely.

Differential Diagnosis:

malignant soft tissue tumor, such as

MFH, liposarcoma (possibly pleomorphic or myxoid type), leiomyosarcoma, synovial sarcoma.

Diagnosis: Proliferative Myositis

Discussion: Proliferative Myositis

Pseudosarcomatous proliferative soft tissue lesion

Common in Adults ( mean age 50 yrs )

Location : Head and neck , Upper Extremities

Histolopathology : Infiltration with basophilic giant cells and proliferative fibroblast

Clinical finding : rapidly enlarging solitary soft tissue mass, firm and painful

Differentials : soft-tissue tumors (angiomatous lesions, lipoma, MFH, sarcomas), traumatic injury, myositis ossificans, muscle sarcoidosis, etc.

Treatment : Local excision or Observation

References:

Radiology 2007 ; 244 : 613 - 616

Radiographics 2004 24 : 1477-1481

Correct Answer
Name	Institution
Total Applicants (7)

Correct Answer (4)
김성윤: 서울아산병원(전공의)
김완태: 서울보훈병원
김혜린: 부천순천향병원 (전공의)
오경진: 분당서울대병원

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