53-year-old female with tense swelling of the right palm along the thenar muscles for a year. X-rays negative. Note is made of a lobulated mass along the volar aspect of the first metacarpal which demonstrates fat signal intensity on all pulse sequences with thin peripheral enhancement on postcontrast sequences, measuring 3.9 x 3.1 x 3.9 cm (TR by AP by CC) most consistent with a lipoma. There is associated medial displacement of the adductor and abductor pollicis musculature. A skin marker overlies the volar aspect of the aforementioned mass presumably corresponding to the patient's palpable area of concern. There are subcentimeter foci of fluid signal intensity within the base of the second metacarpal with thin peripheral enhancement on postcontrast sequences which may represent subchondral cyst formation or ganglion. No additional bone marrow signal abnormalities are identified. The remainder of the flexor and extensor tendons appear intact. The imaged musculature of the right hand is normal in appearance.
Findings most consistent with a lipoma along the volar aspect of the first metacarpal.