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Clinical Features:

A 67-year-old male patient came with right calf swelling for 2 years.


Ultrasound Features:

- An ovoid heterogeneously hypoechoic well-defined mass with tapered ends with no definite surrounding architectural distortion is noted along the right gastrocnemius muscle.

- Color Doppler shows internal vascularity with predominantly peripheral flow (RI: 0.84).


Remember:

- Target sign: Central hyperechogenicity representing fibrocollagenous component surrounded by peripheral hypoechogenicity representing myxoid component; more commonly seen in neurofibroma.

- Intratumoral hemorrhage may lead to sudden increase in tumor size.


Ultrasound Diagnosis:

Peripheral Nerve Sheath Tumor 


Ultrasound Images:





An ovoid heterogeneously hypoechoic well-defined mass with tapered ends with no definite surrounding architectural distortion is noted along the right gastrocnemius muscle


Tapered end shows tibial nerve


Moderate vascularity on power Doppler



Moderate vascularity on color Doppler


Spectral Doppler shows high resistant flow in the supplying artery


3D view of the tumor

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