EP29.06: Do not overlook the extremities: prenatal detection of fibrosarcoma of the hand

Abstract

Tumours of the hand can arise from various tissues and may present before birth. These tumours are rare and prenatal detection plays an important role in the understanding of the natural history and pathophysiology, which may be associated with serious illness or even death in the fetal or neonatal period. We present the case of a 29-year-old second gravida who came for an anomaly scan at 23 weeks of gestation. The ultrasound examination revealed a hypoechoic mass lesion along the dorsal aspect of the left hand (figure1) measuring 4.7 × 4.0 cm in size. Power Doppler examination showed moderate central and perilesional vascularity (figure 2a,b). Colour Doppler and 3D power Doppler showed dilated radial and ulnar arteries in the forearm (figure 3 a,b). On spectral Doppler, low impedance flow seen within the mass lesion (figure 4). No other associated anomaly was seen. Fetal magnetic resonance imaging (MRI) of the mass showed a low-signal-intensity soft tissue mass on T1-weighted imaging and inhomogeneous high-signal-intensity on T2-weighted imaging (figure 5a,b). The mass was seen in the subcutaneous plane overlying the wrist and proximal part of the hand and there was no cortical destruction or marrow involvement. During the course of the pregnancy, the mass showed significant increase in the size with associated increase liquor at 28 weeks of gestation. The patient went into preterm labour at 31 weeks of gestation due to polyhydramnios and delivered a male baby who developed neonatal respiratory distress and died. The histopathological examination of the mass provided a diagnosis of fibrosarcoma. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.