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Findings A large, multilobutlated mass is present along the ulnar aspect of the hand that propagates proximally into the forearm particularly along the course of the ulnar neurovascular bundle and then with subtle extension along the course of the tissue plane about the basilic vein. The mass is low on T1 and prominently high on PD and IR imaging. It demonstrates moderate, nodular enhancement and increased vascularity.
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Diagnosis: Myxoinflammatory Fibroblastic Sarcoma (MIFS) MIFS is a malignant neoplasm frequently found along the distal extremities with extension along fascial planes and particularly may extend along/about tendon sheaths and neurovascular bundles. The myxoid component causes the markedly high T2 signal intensity. The enhancement pattern can be variable often depending on the degree of de-differentiation of the neoplasm. The extension along tissue planes generates a “tail of tissue” that frequently leads to wide excisions and likely the high recurrence rate associated with this neoplasm. Although many soft tissue tumors are difficult to differentiate the somewhat unique characteristics of this neoplasm make prospective diagnosis prior to surgery possible.
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References Myxoid Soft-Tissue Neoplasms: Comprehensive Update of the Taxonomy and MRI Features. Akshay D. Baheti, Sree Harsha Tirumani, Michael H. Rosenthal, Stephanie A. Howard, Atul B. Shinagare, Nikhil H. Ramaiya1, Jyothi P. Jagannathan. American Journal of Roentgenology. 2015;204: 374385. 10.2214/AJR.14.12888
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