Tendon sheath fibroma
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Tendon sheath fibromas is a rare proliferative mass, with common imaging features of tenosynovial giant cell tumours.
Epidemiology
There is a 3:1 male predominance and arise between the 2nd to 5th decades 2.
Pathology
Tendon sheath fibromas are lobulated, round-to-oval, encapsulated masses consisting of spindle cells and collagen fibres that arise from the synovium of a tendon sheath 1,2.
Location
Tendon sheath fibromas can arise around 2,3:
- small joints
- finger (~50%)
- hand (~25%): most commonly the flexor surface
- wrist (~10%)
- large joints (~5%): knee, shoulder, elbow and ankle
They can be intra-articular or extra-articular 2.
RadiographicsRadiographic features
MRI
- T1: low-to-iso signal
- T2: heterogeneous
- GRE: absent susceptibility artifact
- T1C+: no or variable contrast enhancement
Treatment and prognosis
Treatment is usually surgical excision. There is a very low recurrence rate, and these tumours are not reported to have undergone malignant transformation 3.
Differential diagnosis
- tenosynovial giant cell tumour: will often show susceptibility artifact on GRE 1
- nodular fasciitis 2
-</ul><p>They can be intra-articular or extra-articular <sup>2</sup>.</p><h4>Radiographics features</h4><h5>MRI</h5><ul>- +</ul><p>They can be intra-articular or extra-articular <sup>2</sup>.</p><h4>Radiographic features</h4><h5>MRI</h5><ul>
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