Reason: evaluate for recurrent MPNST History: history of malignant peripheral nerve sheath tumor s/p surgery Note is made of postsurgical changes with interval resection of the reference mass within the posterior compartment of the left thigh. Note is made of multiple foci of enhancement within the subcutaneous tissues along the posterior aspect of the thigh adjacent to multiple foci of metallic susceptibility artifact which likely represent granulation tissue related to prior surgery, however, follow-up examination is recommended to evaluate for interval change (image 38 and 41; series 18). There is a 2.5 x 1.8 cm lobulated heterogeneous mass interposed between the semimembranosus and long head of the biceps femoris along the posterior aspect of the distal femoral metaphysis with foci of increased signal intensity on fluid sensitive sequences, with multiple target signs, as well as minimal, if any, enhancement on postcontrast sequences (image 19; series 13) consistent with neurofibromas. There is a vitamin E capsule overlying the mass presumably corresponding to the patient's surgical scar. There is no involvement of the surrounding musculature of the posterior compartment of the thigh. The reference heterogeneous enhancing mass within the superficial soft tissues along the medial aspect of the left knee measures 4.0 x 1.7 cm, previously 3.9 x 1.6 cm (23; series 19), not significantly changed. There are multiple additional foci of signal abnormality along the course of the sciatic nerve consistent with the patient's known history of neurofibromas. There are subcutaneous nodules about the thigh also consistent with the patient's history of neurofibromatosis.
Interval resection of the large reference mass within the posterior compartment of the left thigh. Multiple punctate foci of enhancement within the subcutaneous tissues along the posterior aspect of the thigh likely represent granulation tissue from prior surgery, however, follow-up examination is recommended to evaluate for interval change. Otherwise no findings to suggest residual or recurrent tumor. Other findings consistent with the patient's history of neurofibromatosis as described above.