History of right foot sarcoma. Assess for recurrence. Again seen are postoperative findings related to resection of myxoinflammatory fibroblastic sarcoma. Overall, skin thickening and dorsal subcutaneous edema has decreased. A nonenhancing fluid collection previously described as a seroma also has decreased in size.There is a tiny, 4 to 5 mm, lobulated enhancing nodule within the subcutaneous fat dorsal to the second/third cuneiforms. The lesion demonstrates increased T2 signal and is also slightly hyperintense to skeletal muscle on T1 images, perhaps due to volume averaging with surrounding subcutaneous fat. It was not seen on the initial postoperative study from 8/4/2014, and we therefore cannot exclude the possibility of residual or recurrent tumor. However, review of the preoperative MRI from 1/14/2014 also shows no definite tumor in this location, and therefore it is possible this may not represent malignancy (e.g., a small neuroma).Mild poorly defined enhancement of the subcutaneous fat is noted along the dorsomedial aspect of the midfoot, which corresponds to hypointense T1 and T2 signal abnormality, and may represent scarring. A small cystic lesion in the navicular bone with surrounding edema and enhancement appears similar to that seen on the prior study and may be degenerative in etiology. The bones and muscles otherwise appear within normal limits.
Postoperative changes related to resection of myxoinflammatory fibroblastic sarcoma with overall decrease in dorsal soft tissue edema. New small enhancing nodule in the dorsal soft tissues of the midfoot may represent tumor recurrence.