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Desmoplastic Fibroblastoma: An Uncommon Tumor With a Relatively Characteristic MRI Appearance. AJR Am J Roentgenol 2020; 215:178-183. [PMID: 32406775 DOI: 10.2214/ajr.19.22163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE. We undertook this study to determine the radiologic features of desmo-plastic fibroblastoma. MATERIALS AND METHODS. We reviewed available radiologic images for 29 pathologically confirmed desmoplastic fibroblastomas, including images from MRI, radiography, ultrasound (US), and CT. RESULTS. The patient population included 14 women and 15 men (mean age, 60 years; range, 23-96 years). Typically, lesions were oval or lobulated and relatively small (mean, 5.6 cm). In 14 of the 22 cases that included patient histories, lesions had grown slowly, with two eventually causing pain. The remaining eight were discovered incidentally. All lesions involved or were below the deep fascia. Lesions were well-defined and associated with muscle (45%), deep fascia (28%), joint (21%), or tendon (7%). MR images were available in 26 cases; 14 included unenhanced and contrast-enhanced studies. On MRI imaging all lesions were well-defined and adjacent to dense connective tissue. On T1-weighted images, lesions showed varying amounts of low and intermediate signal intensity similar to that of tendon and skeletal muscle, respectively. On fluid-sensitive images, lesions were more heterogeneous, generally showing a wider spectrum of decreased to intermediate signal intensity. On contrast-enhanced MR images, enhancement was characteristically peripheral and septal with patchy areas of homogeneity. In the 10 cases with radiographs, images showed negative findings or a nonmineralized mass. The 10 available ultrasound studies showed mixed echogenicity. In eight patients, unenhanced CT showed lesions having attenuation similar to that of skeletal muscle. CONCLUSION. Desmoplastic fibroblastoma is an uncommon neoplasm with a relatively characteristic MRI appearance.
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Lee SM, Ha DH, Kang SH, Kim SW, Choi YR. Desmoplastic fibroblastoma mimicking tenosynovial giant cell tumor encasing a tendon of the foot. Skeletal Radiol 2019; 48:637-641. [PMID: 30229348 DOI: 10.1007/s00256-018-3068-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 02/02/2023]
Abstract
Desmoplastic fibroblastoma is an uncommon, benign fibrous soft tissue tumor that usually occurs in the arms, shoulders, neck, hands, and feet in the fifth to seventh decades of life. In general, it is commonly located in the subcutaneous tissue and skeletal muscle. The authors report an unusual case of a desmoplastic fibroblastoma mimicking tenosynovial giant cell tumor encasing a tendon of the foot in a 72-year-old woman. Ultrasonography revealed an inhomogeneously hypoechoic lobulated soft tissue lesion completely wrapped around the extensor digitorum longus tendon. Color Doppler study revealed increased vascularity in the internal and peripheral portions of the lesion. Magnetic resonance imaging revealed a well-defined, lobulated soft tissue mass encasing the extensor digitorum longus tendon with predominantly isointense signal with some areas of hypointense signal on T1-weighted images, predominantly hyperintense signal with some areas of hypointense signal on T2-weighted images, and inhomogeneous enhancement on fat-suppressed contrast-enhanced T1-weighted images. Surgical excision was performed, and the mass was diagnosed on pathological examination as a desmoplastic fibroblastoma. There has been no previously published radiologic case of a desmoplastic fibroblastoma encasing a tendon of the foot in the literature.
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Affiliation(s)
- Sang Min Lee
- Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea.
| | - Doo Hoe Ha
- Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea
| | - Seung Hun Kang
- Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea
| | - Se-Wha Kim
- Department of Pathology, CHA Bundang Medical Center, CHA University School of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea
| | - Young Rak Choi
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea
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Murata H, Imai K, Nakagawa K, Nishigaki Y. Multimodal radiological imaging of collagenous fibroma arising from the subacromial region in a patient with osteosarcoma: A case report. Mol Clin Oncol 2019; 10:366-370. [PMID: 30847175 DOI: 10.3892/mco.2019.1798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 12/07/2018] [Indexed: 11/05/2022] Open
Abstract
Collagenous fibroma arising from the subacromial region is extremely rare. It is important to distinguish collagenous fibroma from other fibrous tumors including desmoid tumors, to differentiate between the prognoses and management strategies, including surgical treatment. The present case report describes the case of a 42-year-old man with a collagenous fibroma of the subacromial region. He received a follow-up examination following treatment for osteosarcoma. Positron emission tomography (PET) scans used to assess for metastatic lesions indicated uptake in his left shoulder. The maximum standardized uptake value was 2.4. Magnetic resonance imaging demonstrated iso-intensity to muscle on T1-weighted images and iso-intensity with slightly high intensity on T2-weighted images. Post-contrast fat-suppressed magnetic resonance images indicated slightly heterogeneous enhancement of the lesion. There were no notable results from X-rays, bone scintigraphy and thallium-201 scintigraphy. Histological examination revealed collagenous fibroma. To the best of our knowledge, the present case is only the second incidence of collagenous fibroma arising from the subacromial region, and the first description of thallium-201 scintigraphy and PET scans in collagenous fibroma. The multimodal radiological data of this case may be useful for assisting in the differentiation of fibrous tumor types, including collagenous fibroma.
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Affiliation(s)
- Hiroaki Murata
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Kan Imai
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Kazuya Nakagawa
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Yasunori Nishigaki
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
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Tanwar YS, Kharbanda Y, Rastogi R, Singh R. Desmoplastic Fibroma of Bone: a Case Series and Review of Literature. Indian J Surg Oncol 2018; 9:585-591. [PMID: 30538394 DOI: 10.1007/s13193-018-0767-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 05/08/2018] [Indexed: 11/24/2022] Open
Abstract
Desmoplastic fibroma is an uncommon locally aggressive benign tumor of the bone. Patients usually present with a long-standing history of pain and swelling. Radiologically and histologically, it can mimic a variety of tumors. This article presents a report on three cases of desmoplastic fibroma in the proximal humerus, distal femur, and neck femur region. The varied radiographic features and the management of the three cases are described in detail. All the three patients were treated by extended curettage. Follow-up ranged from 2 to 5 years. There were no local or systemic recurrence until the last follow-up. Tumor resection with adequate margins is the preferred treatment, although extended curettage can be an acceptable alternative treatment modality when resection is not possible or acceptable.
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Affiliation(s)
- Yashwant Singh Tanwar
- HNo299, Pocket B, DDA Flats, Sarita Vihar, New Delhi, India.,Department of Orthopedics, Apollo Hospital, New Delhi, 110076 India
| | | | - Ruchi Rastogi
- Department of Radiology, Apollo Hospital, Sarita Vihar, Delhi, 110076 India
| | - Ruchi Singh
- 4Department of Radiation Oncology, Lok Nayak Hospital, Delhi, India
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Yamamoto A, Abe S, Imamura T, Takada K, Enomoto Y, Harasawa A, Matsushita T, Furui S. Three cases of collagenous fibroma with rim enhancement on postcontrast T1-weighted images with fat suppression. Skeletal Radiol 2013; 42:141-6. [PMID: 22829025 DOI: 10.1007/s00256-012-1484-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 06/19/2012] [Accepted: 06/21/2012] [Indexed: 02/02/2023]
Abstract
Collagenous fibroma, also known as desmoplastic fibroblastoma, is a benign fibrous soft tissue tumor showing gradual growth, commonly without aggressive local infiltration. Today, preoperative radiological diagnosis is important to avoid over-treatment and unnecessary extensive procedures, but is difficult because diagnostic imaging findings for collagenous fibroma have not been established. We report MR imaging findings of three collagenous fibromas in correlation with their histopathology. The characteristic rim enhancement on post-contrast T1-weighted images with fat suppression was present in all three cases, and we consider this to represent the difference in vascularity between the outer capsule-like fibrous tissue and the inside of the tumor.
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Affiliation(s)
- Asako Yamamoto
- Department of Radiology, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashiku, Tokyo, Japan.
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Kamata Y, Anazawa U, Morioka H, Morii T, Miura K, Mukai M, Yabe H, Toyama Y. Natural evolution of desmoplastic fibroblastoma on magnetic resonance imaging: a case report. J Med Case Rep 2011; 5:139. [PMID: 21470431 PMCID: PMC3083363 DOI: 10.1186/1752-1947-5-139] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2009] [Accepted: 04/07/2011] [Indexed: 11/10/2022] Open
Abstract
Introduction Desmoplastic fibroblastoma (collagenous fibroma) is a recently described tumor thought to arise predominantly from subcutaneous tissue or skeletal muscle. The natural evolution of this tumor on magnetic resonance imaging has never been described, to the best of our knowledge. We herein report a case of desmoplastic fibroblastoma arising in the thigh and show the longitudinal magnetic resonance imaging findings. Case presentation A 60-year-old Japanese man presented with swelling of the medial side of his right thigh, and he complained of nighttime pain and slight tenderness. Magnetic resonance imaging demonstrated a 4 × 4 cm mass in the right thigh. Open biopsy was performed. The mass was diagnosed histologically as a benign fibrous tumor, and we maintained follow-up without surgical therapy. After one year, magnetic resonance imaging showed an increase in tumor size to 4 × 5 cm, but the histologic findings were the same as those obtained one year earlier. Resection was performed with narrow surgical margins. Pathologic diagnosis was desmoplastic fibroblastoma. Two years after surgery, the patient is free from pain and shows no signs or symptoms of recurrence. Conclusion The natural evolution of desmoplastic fibroblastoma is characterized by no changes in patterns on magnetic resonance imaging despite increasing size. This finding is clinically helpful for distinguishing desmoplastic fibroblastoma with increasing pain from the desmoid tumor.
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Affiliation(s)
- Yusaku Kamata
- Department of Orthopaedic Surgery, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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WATANABE H, ISHIDA Y, NAGASHIMA K, MAKINO T, NORISUGI O, SHIMIZU T. Desmoplastic fibroblastoma (collagenous fibroma). J Dermatol 2008; 35:93-7. [DOI: 10.1111/j.1346-8138.2008.00421.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Collagenous fibroma of the deltoid muscle: clinical, surgical and histopathological aspects. J Orthop Traumatol 2007; 8:91-4. [PMID: 27519894 DOI: 10.1007/s10195-007-0170-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 05/05/2007] [Indexed: 10/23/2022] Open
Abstract
We report the case of a 66-year-old woman with a tumorous swelling of the right shoulder of approximately 6 months' duration with morphological features consistent with desmoplastic fibroblastoma or collagenous fibroma, a benign fibrous soft tissue tumor with distinct clinico-pathological features. Clinical history, radiological and pathological findings are presented and other cases of collagenous fibroma with unusual location are discussed.
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Shimoyama T, Horie N, Ide F. Collagenous fibroma (desmoplastic fibroblastoma): a new case originating in the palate. Dentomaxillofac Radiol 2005; 34:117-9. [PMID: 15829696 DOI: 10.1259/dmfr/22428083] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 49-year-old woman presented with a painless slowly growing but huge polypoid palatal mass. On magnetic resonance imaging (MRI), areas of low signal intensity were consistent with a fibrous tumour. T(1) and T(2) weighted MRI after Gd-DTPA administration highlighted a well-circumscribed, purely soft tissue process. Histological analysis of the operative specimen detected collagenous fibroma (desmoplastic fibroblastoma). The patient remains disease-free 4 years after excision.
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Affiliation(s)
- T Shimoyama
- Department of Oral Surgery, Saitama Medical Center, Saitama Medical School, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
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