Aponeurotic fibroma, also known as calcifying aponeurotic fibroma, and juvenile aponeurotic fibroma is characterized by a

lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by injury or diseases. The term ''Lesion'' is derived from the Latin meaning "injury". Lesions may occur in both plants and animals. Types There is no de ...

that usually presents as a painless, solitary, deep

fibrous Fiber (spelled fibre in British English; from ) is a natural or artificial substance that is significantly longer than it is wide. Fibers are often used in the manufacture of other materials. The strongest engineering materials often inco ...

nodule Nodule may refer to: * Nodule (geology), a small rock or mineral cluster * Manganese nodule, a metallic concretion found on the seafloor *Nodule (medicine), a small aggregation of cells *Root nodule Root nodules are found on the roots of plants, ...

, often adherent to

tendon A tendon or sinew is a tough band of fibrous connective tissue, dense fibrous connective tissue that connects skeletal muscle, muscle to bone. It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding tensi ...

fascia A fascia (; : fasciae or fascias; adjective fascial; ) is a generic term for macroscopic membranous bodily structures. Fasciae are classified as superficial, visceral or deep, and further designated according to their anatomical location. ...

, or

periosteum The periosteum is a membrane that covers the outer surface of all bones, except at the articular surfaces (i.e. the parts within a joint space) of long bones. (At the joints of long bones the bone's outer surface is lined with "articular cartila ...

, on the hands and feet.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). Page 989. McGraw-Hill. . The World Health Organization in 2020 reclassified aponeurotic fibroma nodules as a specific benign type of the

fibroblastic and myofibroblastic tumors Fibroblastic and myofibroblastic tumors (FMTs) are tumors which develop from the mesenchymal stem cells which differentiate into fibroblasts (the most common cell type in connective tissue) and/or the myocytes/ myoblasts that differentiate into ...

. Aponeurotic fibromas are diagnosed based on

histopathology Histopathology (compound of three Greek words: 'tissue', 'suffering', and '' -logia'' 'study of') is the microscopic examination of tissue in order to study the manifestations of disease. Specifically, in clinical medicine, histopatholog ...

and treated by surgical excision. They are more common in males than females.

Signs and symptoms

Aponeurotic fibroma occurs most frequently in the fingers, palms, and soles of the distal extremities. Typically, the tumor is defined as a smaller than 3 cm diameter, firm, non-tender mass that grows slowly. It is prone to infiltrate the surrounding tissue and, following surgical resection, is more likely to recur locally.

Diagnosis

A histological examination is necessary to make a diagnosis. Histologically, the tumor is characterized by

fibroblast A fibroblast is a type of cell (biology), biological cell typically with a spindle shape that synthesizes the extracellular matrix and collagen, produces the structural framework (Stroma (tissue), stroma) for animal Tissue (biology), tissues, and ...

growth and calcification. Imaging results include edematous alterations and subcutaneous neoplastic tumors with hazy margins that appear to be encroaching on the surrounding tissues. The

and

tendon sheath A tendon sheath is a layer of synovial membrane around a tendon. It permits the tendon to stretch and not adhere to the surrounding fascia. It contains a lubricating fluid (synovial fluid) that allows for smooth motions of the tendon during muscl ...

are next to the tumor. While T2WI displays heterogeneous signals, T1WI displays signals that are hypointense to isointense. Additionally, there is heterogeneous contrast enhancement.

Treatment

The treatment of choice for an aponeurotic fibroma is surgical excision.

Epidemiology

Aponeurotic fibroma is a rare tumor. The tumor often manifests in the first or second decade of life, while examples have been documented at birth and 67 years of age. Patients who are male are impacted twice as frequently as those who are female.

References

External links

DermNet

{{Soft tissue tumors and sarcomas Dermal and subcutaneous growths Connective and soft tissue neoplasms Rare diseases Benign neoplasms