The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia;
The Departments of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia.
Skinmed. 2023 Sep 29;21(4):280-281. eCollection 2023.
A 61-year-old woman presented with a 3-year history of painless soft-tissue mass on the right sole. The patient reported gradual growth, with a rapid increase in size over the past few months, leading to difficulty in walking. She had no history of past trauma. Examination revealed a 4-cm ovoid mass located over the ball of the foot. It was firm in consistency, with well-defined margins, a smooth surface, and an overlying normal skin (Figure 1). An ultrasound image revealed an eccentric, hypoechoic, nonvascular subcutaneous lobular mass. A magnetic resonance imaging (MRI) of the foot revealed a well-defined mass arising from the flexor tendon sheath of the right foot. The lesion was heterogeneously hyperin-tense on T1- and T2-weighted images with an avid contrast enhancement. All of the surrounding soft tissues indicated normal signal intensity patterns. There was no associated bony destruction. Histopathologic examination after complete excision of the mass established a well-circumscribed lesion composed of osteoclast-like giant cells and mononuclear cells in a hyalinized stroma, consistent with a giant cell tumor of the tendon sheath (GCT-TS) (Figure 2). There was no recurrence during a 6-month follow-up period (Figure 3).
一位 61 岁女性,右足底无痛性软组织肿块 3 年余。患者自述肿块逐渐增大,近几个月内迅速增大,导致行走困难。既往无外伤史。检查发现右足跖球部有一个 4cm 的卵圆形肿块。肿块质地坚硬,边界清楚,表面光滑,覆盖正常皮肤(图 1)。超声图像显示为偏心性、低回声、非血管性皮下小叶状肿块。足部 MRI 显示右足屈肌腱鞘内起源的界限清楚的肿块。病变在 T1 和 T2 加权图像上呈不均匀高信号,增强扫描呈明显强化。所有周围软组织均呈正常信号强度模式。无相关骨破坏。肿块完整切除后的组织病理学检查显示,边界清楚的病变由破骨样巨细胞和单核细胞组成,位于玻璃样基质中,符合腱鞘巨细胞瘤(GCT-TS)(图 2)。在 6 个月的随访期间无复发(图 3)。