Intramuscular mesenchymal chondrosarcoma surrounded by a split fat sign mimicking a benign lesion.

Mesenchymal chondrosarcoma (MCS) is an aggressive malignant mesenchymal tumour of uncertain differentiation. This is rare, accounting for 2%-4% of chondrosarcomas. Its peak incidence is in the second and third decades, though it can occur at any age. These tumours show a widespread distribution, mainly in bone, but with approximately 40% affecting somatic soft tissue. We present a case of MCS arising within the soleus muscle. The lesion was surrounded by a split-fat sign/fatty rind which is a typical feature of peripheral nerve sheath tumours or other benign intramuscular tumours. However, percutaneous biopsy showed MCS. We highlight how perilesional fat is not exclusive to benign intramuscular lesions and, although much less common, can be associated with malignant lesions. This is, to the best of our knowledge, the first reported case of MCS presenting with a split-fat sign at MRI.

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Competing interests: None declared.