Lab Studies:
None
Other Studies:
Right femur radiographs were normal. Case Photo #1 Case Photo #2 Case Photo #3 Case Photo #4
MRI without contrast showed a lobular lesion, measuring 3 x 2 x 5 cm, within the sartorius muscle adjacent to the adductor canal. It contained infiltrative fat and exhibits high T2 and intermediate T1 signal. Report mentioned concern for a vascular malformation. Case Photo #5 Case Photo #6 Case Photo #7 Case Photo #8 Case Photo #9 Case Photo #10
Ultrasound characterization was recommended.
Consultations:
Patient was referred to an interventional radiologist (IR) who performed a biopsy of the solid lesion under ultrasound. IR recommended surgical excision over cryotherapy due to the proximity of the lesion to the neurovascular structures within the adductor canal. Orthopedic oncology agreed. However, there was concern for the risk of injury to saphenous nerve branches with surgical excision. Orthopedic Oncology did not expect significant long-term differences in muscle strength with excision of the affected portion of the sartorius muscle.
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.