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We describe the case of a 21-year-old woman with a synovial sarcoma of the thigh, who exhibited a soft-tissue metastasis to the shoulder approximately 3 months after her initial presentation. Due to its increasing availability and the recognized importance of MRI in the preoperative evaluation of patients with soft-tissue masses, it is important to be aware of even the uncommon manifestations of frequently encountered soft-tissue sarcomas.

We present a case of primary lymphoma of bone arising in the proximal tibial epiphysis of a 16-year-old boy. To the best of our knowledge, primary lymphoma of bone has not been described previously as a mimicker of chondroblastoma. This case report is intended to increase awareness among clinicians and radiologists that primary lymphoma of bone can present with a long clinical prodrome and initially benign radiographic appearance. Early recognition of this unusual presentation will (hopefully) increase the likelihood of cure. However, it is recognized that in children, primary lymphoma of bone is a rare diagnosis and associated with a poor prognosis unless aggressive treatment is utilized [8].

We report a case of a clinically and radiographically dominant osteosarcoma of the proximal end of the tibia, in which the second skeletal focus of osteosarcoma was apparent on MRI, after having escaped detection on routine radiographs and scintigraphy. Detection of the second lesion significantly altered the subsequent treatment and prognosis. The improved sensitivity of MRI may increase the accuracy of the diagnosis of osteosarcomatosis. Although further study is needed, MRI study of long bones, especially T1-weighted images in the coronal plane, may be considered as a screening procedure to exclude occult skeletal involvement in patients with osteosarcoma and negative standard metastatic evaluation.

We present a case of arthritis of the wrist in an elderly man due to Mycobacterium avium-intracellulare. Prior steroid injections and a surgical procedure on the affected wrist were predisposing risk factors for subsequent mycobacterial involvement of the skeleton. Radiographs demonstrated findings characteristic of tuberculous arthritis: particularly, osteopenia with marginal erosions and diffuse lytic lesions involving the carpals, proximal metacarpals, and distal ends of the radius and ulna. MR scans showed soft-tissue involvement and extensive marrow replacement consistent with infection. It is to be reemphasized that the clinical and radiological findings in this case are very often indistinguishable from TB. The diagnosis depends on the results of tissue culture. Since radiologists are likely to be involved increasingly in interpreting images of immunocompromised patients afflicted with a variety of both typical and atypical infections, it is important occasionally to report rare infections such as that described herein.

A case of extraskeletal osteosarcoma occurring in its most common location, the thigh, is reported. Particular emphasis is given to demonstrating the spectrum of radiological findings, including CT, MRI, and scintigraphy and to illustrate that this entity can metastasize to bone.

The case discussed is that of a 31-year-old woman with long-standing hypertrophy and vascular symptoms of the right lower extremity. The etiology of these abnormalities remained undiagnosed, although the patient was treated symptomatically. Following presentation, both MR images and contrast-enhanced CT scans were adequate for diagnosis of the underlying arteriovenous malformation. This was confirmed by arteriography, and the patient received palliative treatment by sequential intra-arterial embolization.