Date : 00.00.00
Name of the Patient : Abc Xyzkar Mapelmn / M / 20 yrs.
Referred by : Dr. Abc Xyzgrankar.
Examination : M.R.I. of the Left Leg.
CLINICAL PROFILE :
C/O swelling over the left leg since 4 months and paresthesias.
M.R.I. of the left leg was performed using the following parameters :
5 mm thick T1 Weighted and STIR axial images.
4 mm thick T1 Weighted and T2 Weighted coronal images.
4 mm thick T1 Weighted and GRASS sagittal images.
There is evidence of a lobulated mass lesion which is hyperintense to muscle but hypointense to fat on the T1 Weighted images and turns hyperintense to both on the T2 Weighted, STIR and GRASS images within the anterior compartment of the left calf. Few areas which are markedly hyperintense on all the pulse sequences are seen within this lesion and these may represent blood/paramagnetic substances. Also seen within this lesion are areas which are hypointense on the T1 Weighted images and turn markedly hyperintense on the T2 Weighted, STIR and GRASS images and these may represent cystic/necrotic changes.
This lesion appears to be involving the extensor digitorum longus and extensor hallucis longus muscles. The tibialis anterior and peroneus longus/brevis muscles are displaced by this lesion (? involved). Also seen is disruption of the interosseus membrane with extension into the posterior compartment with displacement of the tibialis posterior and flexor hallucis longus muscles. This lesion is seen to drape (3/4th of its circumference) the upper two-thirds of the shaft of the left fibula. It is also seen to abut the left tibia. However no obvious bone destruction or signal change is evident.
The anterior tibial vessels cannot be identified separately from this lesion.
The superior aspect of this lesion is approximately 6.0 cms from the knee joint.
The MRI features are suggestive of a mass lesion within the anterior compartment of the left calf as described and this most likely represents a soft tissue neoplasm. The differential diagnosis may include :
c. Nerve sheath tumor.
d. Soft tissue sarcoma/liposarcoma.