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Fibroma of the Tendon Sheath – A Rare Hand Tumor

100%

Heckert R., Bear J., Summers T., Frew M., Gwinn D., McKay P.

Polish Journal of Surgery

2012

vol. 84

issue 12

651-656

Fibroma of the tendon sheath (FTS) is a rare, benign, soft tissue lesion. Clinically, FTS presents similarly to the more common giant cell tumor of the tendon sheath. It is distinguished histologically by the lack of giant cells, foamy histiocytes and synovial cells. We presented a case of FTS involving the common tendon sheath surrounding the flexor tendons leading to the third metacarpal. A 63-year-old man presented with a 3-month history of a painless mass in his right palm that had recently tripled in size. Examination demonstrated a 5x4 cm firm, nodular, superficial mass that was adherent to the overlying skin. Radiographs of the hand revealed a soft tissue mass without bony abnormality. Ultrasound demonstrated a solid, heterogeneous and hypoechoic mass and computed tomography demonstrated that the mass centered predominantly at the mid and distal portions of the third metacarpal. The patient underwent excisional biopsy of the lesion and a palmar, longitudinal incision was made from the wrist to the third metacarpal. Submitted histologic sections revealed a well-circumscribed lesion closely resembling hyalinized collagen. Neither vascular proliferations, necrosis, nor mitoses were observed. Similarly, multinucleated giant cells, pigment-laden macrophages, and inflammatory cells were also not identified. A diagnosis of FTS was rendered. We provided an additional rare case to the literature of a FTS and highlight the need to consider this entity in the differential diagnosis for any soft tissue lesion in the hand. Three months post surgery the patient demonstrated full range of motion of the hand

Peripheral ossifying fibroma mimicking gingival ulcer: case report

86%

da Silva B. M., Willig D. H., Brown M. A., Machado M. Â. N.

Polski Przegląd Otorynolaryngologiczny

2016

vol. 5(3)

49-54

Peripheral ossifying fibroma (POF) is a non-neoplastic lesion, of uncertain aetiology, that originates from the gums or interdental papillae of the anterior maxilla. . It is most prevalent in the anterior maxilla –in women in the second and third decades of life. The lesion is well-defined with a sessile base and a surface similar in colour to mucosa or red, which may be intact or ulcerated. Clinical features do not confirm the diagnosis of this lesion, which requires histopathology. Our patient - B.M.S, a 23-year-old woman sought help of the Symptomatology Clinic at the School of Dentistry of the Federal University of Paraná, complaining of a “cold sore in the gum” for approximately one month. Clinical examination showed an erythematous area with central ulceration in the gingival margin and attached to the buccal region of tooth 22. Periodontal examination showed absence of bleeding, a periodontal pocket and absence of bone loss in the radiographs. There were no relevant findings in the auxiliary studies. Excisional biopsy was taken and the histopathological examination revealed the presence of dense fibrous stroma of collagen fibres, intermingled with fibroblasts, trabecular bone and a few giant cells, confirming the diagnosis. There was recurrence of the lesion. Surgical excision of the recurrent lesion was performed, including the removal of the periosteum and ligament, accompanied by dental scaling. It was concluded that further differential diagnosis was necessary to rule out clinically similar lesions to POF such as fibrous hyperplasia, peripheral giant cell granuloma and pyogenic granuloma. These lesions can mimic ulcers and therefore it is necessary to conduct histopathological examination to make the diagnosis. Furthermore, in order to minimize the tendency of recurrence of POF, it is essential to remove the underlying periosteum and periodontal ligament in addition to biofilm and calculus.

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1 Polish Journal of Surgery

1 Polski Przegląd Otorynolaryngologiczny

1 2016

1 2012

1 Bear J.

1 Brown M. A.

1 Frew M.

1 Gwinn D.

1 Heckert R.

1 Machado M. Â. N.

1 McKay P.

1 Summers T.

1 Willig D. H.

1 da Silva B. M.

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Fibroma of the Tendon Sheath – A Rare Hand Tumor

Peripheral ossifying fibroma mimicking gingival ulcer: case report