Fibroma of the Patellar Tendon Sheath: A New Paradigm / Fibroma da bainha do tendão patelar: Um novo paradigma

Abstract The authors present a case of fibroma of the tendon sheath with intra-articular location in the knee, more specifically in the infrapatellar fat; with this specific location, this is the fourth case described of an entity that rarely affects large joints. Clinical and epidemiologi-cal aspects, but especially the imaging findings on magnetic resonance imaging scans, are essential for the differential and definitive diagnosis, which was nevertheless established only after a histological study of the excised mass by miniarthrotomy.

Resumo Os autores apresentam um caso de um fibroma da bainha de tendão com localização intra-articular no joelho e origem na gordura infrapatelar. Esta localização específica é extremamente rara, sendo este o quarto caso descrito de uma entidade que raramente afeta grandes articulações. Para o seu diagnóstico aspetos clínicos, epidemiológicos e sobretudo achados imagiológicos da ressonância magnética são fundamentais. Neste caso o diagnóstico definitvo foi apenas estabelecido após estudo histológico da massa excisada por mini-artrotomia.

Intra-Articular Fibroma of Tendon Sheath in a Knee Joint Associated with Iliotibial Band Friction Syndrome

Iliotibial band (ITB) friction syndrome is a common overuse injury typically seen in the active athlete population. A nodular lesion on the inner side of the ITB as an etiology or an accompanying lesion from friction syndrome has been rarely reported. A 45-year-old male presented with recurrent pain and a movable nodule at the lateral joint area, diagnosed as ITB friction syndrome. The nodule was confirmed as a rare intra-articular fibroma of the tendon sheath (FTS) on the basis of histopathologic findings. We describe the MRI findings, arthroscopic and pathologic features, in this case of intra-articular FTS presenting with ITB friction syndrome.

Multiple Fibromas of Tendon Sheath: Unusual Presentation

Fibroma of the tendon sheath is an uncommon soft tissue tumor presenting as a solitary, slow-growing, firm, painless, small nodule, which shows strong attachment to the tendon or tendon sheath. It is usually localized on fingers and hand tendons in adults between the age of 20 and 40 years old. This case concerns a 61-year-old man presenting with a 5-year history of multiple cutaneous nodules on both palms and soles. Skin biopsy confirmed fibroma of the tendon sheath. Blood tests showed a high titer of rheumatoid factor and positivity to anti-nuclear antibody. No case of fibroma of the tendon sheath occurring multifocally on both palms and soles has been previously reported. Herein, we report on a very rare case of multiple fibromas of the tendon sheath arising from palms and soles, which supports the pathogenetic hypothesis that this tumor may be a reactive process rather than a true neoplasm.

Fibroma of the Tendon Sheath Arising from the Synovial Membrane of the Temporomandibular Joint / Oral Science International

Fibroma of the tendon sheath (FTS) involving the temporomandibular joint (TMJ) is very rare. A case of FTS arising from the synovial membrane of the TMJ is presented. The patient was a 17-year-old male with jaw opening pain and clicking in the left TMJ. MRI, arthrotomography, and arthroscopy showed a well-circumscribed mass that was localized in the superior articular cavity of the left TMJ. The tumor was removed with the attached synovial membrane. Macroscopic, histological and immunohistological features of the intra-articular tumor were identical to FTS. There have been no signs of recurrence in the 6 years since surgery.

A Case of Fibroma of the Tendon Sheath on the Elbow / 대한피부과학회지

Fibroma of the tendon sheath is a benign soft tissue tumor and this mostly occurs in the distal portion of an extremity. The tumor usually appears as a slow-growing, firm, painless, small nodule in association with tendons and tendon sheaths. Histopathologically, it shows a well-demarcated nodule that consists of haphazardly-arranged, fibroblast-like spindle cells that are embedded in a dense collagenous matrix. A 52-year-old woman presented with a tender, solitary, 2.5x2.0 cm-sized, subcutaneous nodule on the right elbow. The skin biopsy specimen showed that the well-circumscribed tumor contained densely-arranged collagen areas with spindle cells and slit-like vascular channels. We herein report on a rare case of fibroma of a tendon sheath on the right elbow.

A Case of Fibroma of Tendon Sheath on the Big Toe / 대한피부과학회지

Fibroma of tendon sheath presents as a small subcutaneous nodule that slowly increases in size, and it is most frequently found on the hands, with the thumb being the most common site of involvement. A 60-year-old woman presented with an asymptomatic, solitary, 1.5 x 2.0 cm-sized, firm, subcutaneous nodule on the left big toe. On magnetic resonance imaging view, the tumor was adherent to tendon sheath of the volar aspect of the left big toe. The skin biopsy specimen showed that the well-circumscribed tumor contained hypocellular, hyalinized, collagenous area and hypercellular densely-arranged collagen area with spindle-shaped fibroblasts and slit-like vascular channels. We herein report a rare case of fibroma of tendon sheath on the left big toe.

A Case of Fibroma of Tendon Sheath / 대한피부과학회지

Fibroma of tendon sheath is a benign, soft tissue tumor that presents as a painless mass in the distal portion of an extremity. It is a slow-growing, dense, fibrous nodule which firmly attaches to the tendon sheath, and usually occurs in adults between the age of 20 and 50 years old. Histopathologically, it shows a well-demarcated nodule consisting of haphazardly-arranged, fibroblast-like spindle cells, which are embedded in a dense collagenous matrix. It is thought to be either a reactive process or a neoplasm, and the recurrence rate after excision is reported to be 24%. Herein, we present a typical case of fibroma of tendon sheath in a 39-year-old female, who presented with a firm nodule on her left 2nd finger. This was confirmed by histopathologic findings. The information described above should carefully be taken into consideration during differential diagnosis of soft tissue tumors of the hand.

A case of fibroma of tenden sheath / 대한피부과학회지

We report a case of fibroma of tendon sheath developed in a 22-year-old woman. The tumor of about 5 years duration was protruding on the volar surface of her 4th finger tip. It was well-demarcated rubbery-hard, and immovable on palpation. The surface on the tumor was smooth and had some telangiectasias. It was asymptomatic and non-tender. The histopathologic findings of excised specimen revealed well-demarcated lobulated mass with widely-spacd: fibroblasts in a hyalinized collagenous matrix. The characteristic slit-like spaces were found in hypoellular and fasciitis-like region. After excision, local recurrence has not been observed for about one and a half years of follow-up period.

A case of fibroma of tenden sheath / 대한피부과학회지

We report a case of fibroma of tendon sheath developed in a 22-year-old woman. The tumor of about 5 years duration was protruding on the volar surface of her 4th finger tip. It was well-demarcated rubbery-hard, and immovable on palpation. The surface on the tumor was smooth and had some telangiectasias. It was asymptomatic and non-tender. The histopathologic findings of excised specimen revealed well-demarcated lobulated mass with widely-spacd: fibroblasts in a hyalinized collagenous matrix. The characteristic slit-like spaces were found in hypoellular and fasciitis-like region. After excision, local recurrence has not been observed for about one and a half years of follow-up period.