Reason: Right forearm soft tissue sarcoma in volar compartment that may originate from the median nerve, please evaluate for discernable plane between the nerve and the mass History: above There is a large mass within the anterior compartment of the forearm, which measures approximately 5.5 x 5.0 cm in transverse dimension and 13.0 cm in craniocaudal dimension. The flexor carpi radialis muscle/tendon are displaced laterally and the flexor carpi ulnaris muscle/tendon are displaced medially. What we believe to be the palmaris longus tendon is displaced volarly. The mass focally protrudes into the volar subcutaneous fat of the forearm just lateral to the palmaris longus tendon. Just distal to this, the palmaris longus tendon is focally enveloped by the mass. The remaining flexor tendons are displaced dorsally, although what we suspect to be the superficial flexor tendon of the middle finger is enveloped by the mass. The median nerve is dorsally displaced by the mass, and runs along the dorsal margin of the mass. The superficial branch of the radial nerve may contact the mass focally, but this is equivocal, and it does not appear to be enveloped by the mass. The mass itself is slightly hyperdense to skeletal muscle on T1-weighted images. It is heterogeneously hyperintense to muscle on fat-suppressed T2-weighted images and shows heterogeneous enhancement following intravenous administration of gadolinium. The mass also shows hyperintensity on the fat-suppressed T1-weighted images, which likely represents areas of hemorrhage. The proximal margin of the mass lies approximately 8 cm distal to the elbow joint with a small tail of enhancing edema extending more proximally. The distal edge of the mass is at the level of the radiocarpal joint. The median nerve within the carpal tunnel appears enlarged, likely reflecting neuritis. The bone marrow signal intensity appears normal.
Large heterogeneous mass in the anterior compartment of the forearm as described above with dorsal displacement of the median nerve.