A 35-Year-Old Male with a Soft Tissue Mass on His Finger

Differential Diagnosis

• Liposarcoma
• Nodular fasciitis
• Peripheral nerve sheath tumor
• Soft tissue mass with chronic bony erosive changes

Diagnosis

The image reveals focal soft tissue prominence and increased density of soft tissues radial aspect second digit adjacent to the middle phalanx, with adjacent lucency of radial aspect middle phalanx with well-defined sclerotic margin.

The correct diagnosis is soft tissue mass of the second digit with chronic bony erosive changes without aggressive features.

Learnings/What to Look for

• Masses associated with bony erosion include glomus tumor, tendon sheath giant cell tumor, lipoma, and synovial sarcoma
• Gout can also produce adjacent erosions
• Glomus tumor tends to be painful

Pearls for Urgent Care Management

• Soft tissue tumors involving the hand are common and most often benign
• MRI is useful for further evaluation

Acknowledgment: Image and case presented by Experity Teleradiology (www.experity.com/teleradiology).