16-year-old patient presented with lump in his hand

 

Images

Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Afarin Sadeghian

 

Case Section

Muskuloskeletal System

 

Patient's Information

Gender : Male
Age : 16

 

Clinical Summary

16-year-old patient presented with lump in his hand

 

Imaging Findings

The images show an ovoid mass with lobulated outline affecting dorsal aspect of the hand which is isointense on T1-weighted and hyperintense on T2-weighted with areas of low signal intensity on both sequences.The mentioned mass most probably arising from interosseus musles and enhances avidly after IV gadolinium administration.Splaying of the muscle tendons without encasement and displacement of the metacapal bones without cortical or medullary signal changes are noted.

 

Differential Diagnosis

1.Malignant soft-tissue sarcoma,2.Extranodal lymphoma,3.Benign myositis ossificans, 4.Arteriovenous malformation

 

Final Diagnosis

Deep(aggressive)fibromatosis with previous history of abdominal fibromatosis 5 years ago and extraabdominal fibromatosis 3 years ago reported on case 274 earlier

 

Discussion (Related Text)

Fibromatosis is a rare mesenchymal tumor characterized histologically by proliferation of fibroblasts and myofibroblasts with marked production of intercellular collagen. It comprises a broad group of fibrous tissue proliferations of similar histologic appearance that has biologic behavior intermediate between that of benign fibrous lesions and fibrosarcoma.Unlike fibrosarcoma, fibromatosis never metastasizes and is, therefore, classified as a benign neoplasm. However, it is characterized by an infiltrative growth pattern and a tendency toward local recurrence.Most cases are sporadic, but there is a clear association with familial adenomatous polyposis and Gardner’s syndrome, suggesting a link with mutations of the APC gene on chromosome 5q22.Fibromatosis can be divided into two major groups with several subdivisions by clinical presentation, patient age, and natural history. Occurring in almost any anatomic location, it can be divided into superficial and deep subtypes. The superficial fibromatoses are usually small (< 5 cm) slow- growing lesions that rarely involve deep structures. The deep group consists of rapidly growing lesions that often reach a large size and have a high tendency to recur after treatment, hence the term “aggressive fibromatosis.” This group principally involves the musculature of the trunk and the extremities. However, we could define term “desmoid” to be synonymous with abdominal wall aggressive fibromatosis.

 

References

AJR 2006; 186:247–254

 

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