Benign soft-tissue lesions of the fingers: radiopathological correlation and clinical considerations

Abstract

Soft-tissue lesions of the fingers are commonly found in daily clinical practice. A wide range of tumors and pseudotumors have been described in this location, and the majority of them are benign. Ganglion cysts are the most common entity, and the localized type of tenosynovial giant cell tumors are the most frequent solid condition. Both may be easily recognized owing to their typical clinical and radiological characteristics. However, categorization of the spectrum of soft-tissue lesions of the fingers remains limited, despite imaging development, and many patients undergo surgery before radiological or histological diagnosis. Clinical history, radiographic features, and ultrasound and magnetic resonance patterns may help in obtaining the correct diagnosis or reducing the list of differential diagnoses. Radiologists should be familiar with imaging findings so that they can determine the size, extension, and affected neighboring anatomical structures, and provide information that allows adequate presurgical counseling.

ACR Appropriateness Criteria® Clinically Suspected Vascular Malformation of the Extremities

“…MRI offers superior soft-tissue contrast compared with CT and plays an important role in the workup of suspected vascular malformations and softtissue masses. Lesion morphology and internal signal characteristics can be assessed, often allowing for definitive diagnosis [2][3][4]6,7,9,19]. MRI accurately determines lesion extent and involvement of surrounding structures, both of which are underestimated clinically in up to 76% of cases [2,5,7].…”

“…IV contrast also allows better visualization of the feeding and draining vessels in high-flow lesions, although this is best performed using an MRA protocol [1][2][3]6,7,21]. Additionally, MRI is useful for the evaluation of other soft-tissue lesions and musculoskeletal pathologies that might be considered in the differential diagnosis for a mass, enlarged extremity, or pain [19,20,22,23].…”

“…The high tissue contrast of MRI makes it a preferred modality to assess the extent and distribution of vascular malformations, which are often underestimated by physical examination alone [2,5]. MRI is also a good option to evaluate for other soft-tissue lesions that may be included within a differential diagnosis of bruit on clinical examination [19,23]. The use of IV contrast improves lesion characterization and optimizes visualization of the surrounding anatomy [3,6,20].…”

Giant infiltrating intermuscular angiolipoma of the posterior axioappendicular region: gross and microscopic features

“…According to the 2002 and 2013 modi ed W.H.O (World Health Organization) bone and soft tissue tumor classi cation, lipomatous tumors are soft tissue tumors and are histologically subdivided into lipoma, lipomatosis, lipomatosis of nerve, lipoblastoma, angiolipoma, chondroid lipoma, myolipoma, spindle-cell lipoma, hibernoma, and dedifferentiated liposarcoma (Bancroft et al, 2006;Jo & Fletcher, 2014;Laurence, 2004;Pernas et al, 2014). Angiolipoma is a subcutaneous nodule having mature adipocytes mixed with small vessels most of which having thrombi (Laurence, 2004).…”

“…Angiolipoma is a subcutaneous nodule having mature adipocytes mixed with small vessels most of which having thrombi (Laurence, 2004). The W.H.O has classi ed angiolipomas as in ltrating or non-in ltrating types (Bancroft et al, 2006;Jo & Fletcher, 2014;Laurence, 2004;Pernas et al, 2014). The in ltrating ones are very rare and partially or completely penetrate deep into the soft tissues mimicking aggressive tumors.…”