PMC4898174_01
73-year-old female with spindle-cell sarcoma. Initial MRI study. Sagittal T1W T1 fat-suppressed contrast-enhanced image of the left knee shows a tangle of vessels in the subcutaneous soft tissues posterior to the neurovascular bundle and medial head of gastrocnemius musculature. Extension over proximal calf (arrow) with marked enhancement on the postcontrast images (arrow) was erroneously thought to represent a venous angioma. Note intermediate signal intensity of the lesion.
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fig1A
T1W fat-suppressed sequences following intravenous administration of gadolinium-based contrast (Figure 1A, Figure 1B, Figure 1C, Figure 1D). The lesion measured approximately 6.3 (craniocaudal) x 3.2 (transverse) x 0.7 (anteroposterior) cm. There were no other focal soft-tissue or bony abnormalities.
73-year-old female with spindle-cell sarcoma. Initial MRI study. Axial PDW fat-suppressed T1 fat-suppressed contrast-enhanced image of the left knee shows a tangle of vessels in the subcutaneous soft tissues posterior to the neurovascular bundle and medial head of gastrocnemius musculature. Extension over proximal calf (arrow) with marked enhancement on the postcontrast images (arrow) was erroneously thought to represent a venous angioma. Note intermediate increased signal intensity of the lesion as well as connections with the popliteal vein (open arrow).
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fig1B
The previously seen presumed "venous angioma" was visualized at the posterior aspect of the lesion and appeared ill-defined (Figure 2A, Figure 2B, Figure 2C, Figure 2D). These findings were consistent with an aggressive/malignant, locally invasive soft-tissue tumor/sarcoma that prompted an excisional biopsy.
73-year-old female with spindle-cell sarcoma. Initial MRI study. Axial T1 fat-suppressed contrast-enhanced image of the left knee shows a tangle of vessels in the subcutaneous soft tissues posterior to the neurovascular bundle and medial head of gastrocnemius musculature. Eextension over proximal calf (arrow) with marked enhancement on the post contrast images (arrow) was erroneously thought to represent a venous angioma. Note intermediate signal intensity of the lesion as well as connections with the popliteal vein (open arrow).
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fig1C
The neoplastic cells were mitotically active and pleomorphic, with some areas of myxoid stroma (Figure 3A, Figure 3B, Figure 3C).