PMC9826560_01
Anterior posterior radiograph of foot shows a lytic mildly expansile lesion (red arrow) in first metacarpal with wide zone of transition and no sclerotic margin.
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F1
Radiographs of the foot showed a lytic expansile lesion in first metacarpal with wide zone of transition, no sclerotic margin, and no matrix calcification (Fig. 1).
(a and b) Sagittal T2FS and sagittal T1 images reveal a fluid intensity mildly expansile intramedullary lesion (red arrows) causing cortical scalloping.
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F2
It was heterogeneously hyperintense on T2W images, hypointense on T1W images, with slow progressive peripheral nodular enhancement in dynamic contrast-enhanced MRI (DCEMRI) curves, and area of cortical breach with extraosseous soft-tissue component (Fig. 2a, b, 3, 4).
Axial post-contrast image shows heterogeneous enhancement in the intramedullary lesion (red arrow). Mild extraosseous soft-tissue is seen.
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F3
It was heterogeneously hyperintense on T2W images, hypointense on T1W images, with slow progressive peripheral nodular enhancement in dynamic contrast-enhanced MRI (DCEMRI) curves, and area of cortical breach with extraosseous soft-tissue component (Fig. 2a, b, 3, 4).
Dynamic curves-red curve which demonstrates slow progressive uptake is suggestive of neoplastic lesion. Region of interest red curve: Neoplastic lesion. Green curve: Muscle. Yellow curve: Within the vessel.
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F4
It was heterogeneously hyperintense on T2W images, hypointense on T1W images, with slow progressive peripheral nodular enhancement in dynamic contrast-enhanced MRI (DCEMRI) curves, and area of cortical breach with extraosseous soft-tissue component (Fig. 2a, b, 3, 4).
Cor diffusion-weighted imaging and apparent diffusion coefficient shows few areas of restricted diffusion in the periphery of the lesion (red arrows).
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F5
Few areas of diffusion restriction were noted within the lesion (Fig. 5).
(a and b) HPE shows hypocellular tumor composed of short spindle and stellate shaped tumor cells embedded on a markedly myxoid stroma without any chondroblasts or osteoclastic giant cells.
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F6
The biopsy demonstrated a hypocellular tumor composed of short spindle and stellate shaped tumor cells embedded on a markedly myxoid stroma without any chondroblasts or osteoclastic giant cells on HPE (Fig. 6a and b).
(a and b) IHC showing spindle shaped tumor cells positive for smooth muscle actin and Vimentin and negative for synaptophysin-100, cluster of differentiation 34 and desmin.
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F7
Immunohistochemistry was positive for smooth muscle antigen, vimentin and negative for synaptophysin-100, cluster of differentiation 34, desmin (Fig. 7a and b).