Pseudotumor of Hand Foreign Body Granuloma

Abstract

Foreign body granuloma develops following a skin penetrating injury with retention of a foreign body, which subsequently causes a reactive inflammatory granulation tissue around it. It can mimic as a pseudotumor; hence, its early detection and diagnosis with imaging can help in its management and prevent further complications. We report a 10-year-old boy with swelling on the dorsum of the hand causing scalloping of the 3rd metacarpal presenting as pseudotumor and was confirmed to be a foreign body (thorn) granuloma on ultrasonography and magnetic resonance imaging (MRI). The characteristic appearance of foreign body in soft tissue on ultrasound is an echogenic structure giving posterior acoustic shadowing, and on MRI it typically appears as a low signal intensity structure on T1- and T2-weighted images with peripheral ring enhancement. Hence, the possibility of a foreign body granuloma should be ruled out in cases of suspected soft tissue neoplasm in extremities, despite no significant history of previous trauma.