Is Magnetic Resonance Imaging Able to Provide Specific Diagnoses? A Case Report of Clear Cell Sarcoma of Soft Tissue in the First Metacarpal of the Hand.

Introduction: Clear cell sarcoma (CCS) of the soft tissue is a type of tumor that primarily affects the deep soft tissues of the extremities and trunk. We report a case of CCS of soft tissue arising in the first metacarpal of the hand, focusing on the imaging features of CCS combined with the clinicopathological and immunological results.

Case Presentation: In this case, computed tomography images showed a soft tissue mass at the first metacarpal, with heterogeneous density, unclear boundaries, and bone destruction. On magnetic resonance imaging (MRI), the mass showed slightly higher signal intensity on T1-weighted images and mixed hyperintensity on T2-weighted images, with inhomogeneous enhancements. On both T1-weighted and T2-weighted sequences, there were some hypointense strips. No significant enhancements were found in these hypointense strips.

Conclusion: We suggest that hypointense strips on MRI should lead to the inclusion of CCS in differential diagnoses.