Presentation
No past medical history who presented with right leg swelling for three weeks and no history of trauma.
Patient Data
Contributing Author: Dr. Rajeev Varma, Harbor-UCLA Medical Center, Los Angeles, CA
There is a 13 cm well-circumscribed mass with cystic components within the adductor magnus muscle in the mid-thigh. The solid components appear slightly hyperintense to muscle on T1 weighted imaging. There are serpiginous foci within the mass which demonstrate low signal on all sequences. There is very little edema within the surrounding musculature. The neurovascular bundle is displaced. The bones are normal.
Case Discussion
A differential diagnosis for this case includes atypical infection (in the lesion there is a serpentine hypointense signal which can be seen in intramuscular hydatid disease - serology suggested prior to biopsy) and a soft tissue sarcoma such as synovial sarcoma or malignant fibrous histiocytoma.
Echinococcus antibodies were positive. The patient was treated with albendazole and referred to surgery for potential en bloc resection.
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