case_images: PMC9826560_01
case_images: 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.
case_images: JOCR-12-35-g001.jpg
case_images: PMC9826560_01_JOCR-12-35-g001.jpg
case_images: F1
case_images: 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).
case_images: (a and b) Sagittal T2FS and sagittal T1 images reveal a fluid intensity mildly expansile intramedullary lesion (red arrows) causing cortical scalloping.
case_images: JOCR-12-35-g002.jpg
case_images: PMC9826560_01_JOCR-12-35-g002.jpg
case_images: F2
case_images: 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).
case_images: Axial post-contrast image shows heterogeneous enhancement in the intramedullary lesion (red arrow). Mild extraosseous soft-tissue is seen.
case_images: JOCR-12-35-g003.jpg
case_images: PMC9826560_01_JOCR-12-35-g003.jpg
case_images: F3
case_images: 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).
case_images: 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.
case_images: JOCR-12-35-g004.jpg
case_images: PMC9826560_01_JOCR-12-35-g004.jpg
case_images: F4
case_images: 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).
case_images: Cor diffusion-weighted imaging and apparent diffusion coefficient shows few areas of restricted diffusion in the periphery of the lesion (red arrows).
case_images: JOCR-12-35-g005.jpg
case_images: PMC9826560_01_JOCR-12-35-g005.jpg
case_images: F5
case_images: Few areas of diffusion restriction were noted within the lesion (Fig. 5).
case_images: (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.
case_images: JOCR-12-35-g006.jpg
case_images: PMC9826560_01_JOCR-12-35-g006.jpg
case_images: F6
case_images: 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).
case_images: (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.
case_images: JOCR-12-35-g007.jpg
case_images: PMC9826560_01_JOCR-12-35-g007.jpg
case_images: F7
case_images: Immunohistochemistry was positive for smooth muscle antigen, vimentin and negative for synaptophysin-100, cluster of differentiation 34, desmin (Fig. 7a and b).