Epithelioid hemangioendothelioma Foot: Multiple small foci of signal void are noted within the medial soft tissues of the midfoot representing metallic susceptibility artifact from prior surgical intervention. The previously seen enhancing mass within the abductor hallucis muscle inferior to the medial cuneiform has been resected. In its place is a collection of high signal intensity on both T1 and T2 sequences measuring just under 1 cm in the transverse dimension and just under 2 cm in the longitudinal dimension. This collection likely represents a small hematoma. There is mild edema and enhancement of the adjacent muscles and soft tissues likely representing postoperative inflammation and/or early scarring. There is otherwise no well-defined enhancing mass to suggest recurrent or residual tumor. There are no additional soft tissue or bony masses affecting the foot. Note is made of a bipartite medial sesamoid (normal variant) and mild osteoarthritis of the first MTP joint.Tibia/Fibula: There are no masses or abnormal foci of enhancement within the bones or soft tissues of the tibia or fibula. Although the exam was not tailored for the evaluation of the knee, there appears to be a shallow femoral trochlea with lateralization of the tibial tuberosity with relation to the trochlea. This can be further evaluated with MRI of the knee, if clinically warranted. There is mild edema type signal within the distal soleus along the myotendinous junction of the Achilles which may represent a mild strain but this is equivocal and of doubtful clinical significance.
Surgical changes of epithelioid hemangioendothelioma resection from the medial midfoot with a small residual hematoma. There is no evidence of residual or recurrent mass within the foot or and no evidence of mass or signal abnormality within the leg. Other findings are described above.