Investig Magn Reson Imaging.  2016 Jun;20(2):136-139. 10.13104/imri.2016.20.2.136.

Clear Cell Sarcoma of the Wrist: MRI Findings with Diffusion-Weighted Image and Histopathologic Correlation

• Chung BY
• Lee SA
• Choi JA
• Shim JW

• KMID: 2327428
• DOI: http://doi.org/10.13104/imri.2016.20.2.136

Abstract

Clear cell sarcoma is rare and difficult to diagnose. Herein, we present a case of clear cell sarcoma in the dorsum of the wrist with MRI findings, including diffusion-weighted imaging, and histopathologic correlation, which was initially diagnosed as giant cell tumor of tendon sheath.

Keyword

Clear cell sarcoma; Malignant melanoma of soft parts; Wrist; Magnetic resonance imaging; Diffusion magnetic resonance imaging; Histopathology

MeSH Terms

Diffusion Magnetic Resonance Imaging
Giant Cell Tumors
Magnetic Resonance Imaging*
Sarcoma, Clear Cell*
Tendons
Wrist*

Figure

• 

  Fig. 1 A 54-year-old woman with clear cell sarcoma (malignant melanoma of soft parts) on the dorsum of the left wrist. (a) Axial and (b) sagittal T1-weighted images, (c) axial and (d) sagittal T2-weighted images demonstrate a well-marginated, lobulated mass with heterogeneous intermediate to high signal intensity compared with muscle. (e) Post-contrast image (TSE, TR/TE 720/12) clearly shows the heterogeneously enhancing mass at the dorsum of the wrist. (f) Corresponding axial ADC map (b = 0, 400, and 1400 sec/mm2) shows an area of low signal intensity that correspond to the tumor, with minimum and average ADC values of 0.52 × 10-3 mm2/sec and 0.93 × 10-3 mm2/sec, respectively. (g) Diffusion-weighted axial image (b = 1400 sec/mm2) shows high signal intensity for most part of the lesion.

• 

  Fig. 2 Histopathologic findings. (a) Clusters or nests consist of tumor cells with surrounding abundant fibrovascular stroma (Hematoxylin & Eosin, original magnification × 40). (b) Immunohistochemistry shows strongly positive immunoreactivity for melan-A protein (× 400).

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