PMC2797755_01
T1 (coronal (a), sagital (b), axial (d), and (e)):and T2 fat saturated (sagital (c)):weighted images of the left pelvis and hip. There is a 2.9 x 3.4 x 3.2 cm lobulated mass involving the sciatic nerve at the sciatic notch (arrow). It is hyperintense on T1 and T2 fat saturated images. Adjacent musculature, gluteus medius, and gluteus minimus are atrophic and have edematous changes (arrowhead).
CRM2009-810973.001.jpg
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fig1
A repeat MRI of her left thigh and pelvis was essentially unchanged from the prior study (Figure 1).
Hemotoxylin and eosin stained biopsy sections reveal (a) focal stromal myxoid changes (arrows), mild inflammatory infiltration, fibrosis, and (b) areas of synovial proliferation.
CRM2009-810973.002.jpg
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fig2
A nonconductive area of the nerve, identified by intraoperative stimulation, was biopsied and microscopically demonstrated a cyst wall with adjacent areas of synovial cell & perineural sheath proliferation, small collections of mucoid debris, foci of mild chronic inflammation, and myxoid degeneration (Figure 2).