Tendon sheath fibroma
Updates to Article Attributes
Tendon sheath fibromas is aare rare proliferative mass,lesions with common imaging features of tenosynovial giant cell tumours.
Epidemiology
There isThey are found in adults typically between the age of 20 and 50 with 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.
Radiographic features
MRI
T1:
:low-to-iso signalT2:
:heterogeneousGRE:
:absent susceptibility artifactT1CT1 C+ (Gd)::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
-<p><strong>Tendon sheath fibromas</strong> is a rare proliferative mass, with common imaging features of <a href="/articles/tenosynovial-giant-cell-tumour">tenosynovial giant cell tumours</a>.</p><h4>Epidemiology</h4><p>There is a 3:1 male predominance and arise between the 2nd to 5th decades <sup>2</sup>.</p><h4>Pathology</h4><p>Tendon sheath fibromas are lobulated, round-to-oval, encapsulated masses consisting of spindle cells and collagen fibres that arise from the synovium of a <a href="/articles/tendon-sheath">tendon sheath</a> <sup>1,2</sup>. </p><h5>Location</h5><p>Tendon sheath fibromas can arise around <sup>2,3</sup>:</p><ul>-<li>small joints<ul>-<li>finger (~50%)</li>-<li>hand (~25%): most commonly the flexor surface</li>-<li>wrist (~10%)</li>- +<p><strong>Tendon sheath fibromas</strong> are rare proliferative lesions with common imaging features of <a href="/articles/localised-tenosynovial-giant-cell-tumour-1">tenosynovial giant cell tumours</a>.</p><h4>Epidemiology</h4><p>They are found in adults typically between the age of 20 and 50 with a 3:1 male predominance <sup>2</sup>.</p><h4>Pathology</h4><p>Tendon sheath fibromas are lobulated, round-to-oval, encapsulated masses consisting of spindle cells and collagen fibres that arise from the synovium of a <a href="/articles/tendon-sheath">tendon sheath</a> <sup>1,2</sup>. </p><h5>Location</h5><p>Tendon sheath fibromas can arise around <sup>2,3</sup>:</p><ul>
- +<li>
- +<p>small joints</p>
- +<ul>
- +<li><p>finger (~50%)</p></li>
- +<li><p>hand (~25%): most commonly the flexor surface</p></li>
- +<li><p>wrist (~10%)</p></li>
-<li>large joints (~5%): knee, shoulder, elbow and ankle</li>- +<li><p>large joints (~5%): knee, shoulder, elbow and ankle</p></li>
-<li>-<strong>T1</strong>: low-to-iso signal</li>-<li>-<strong>T2</strong>: heterogeneous</li>-<li>-<strong>GRE</strong>: absent <a href="/articles/magnetic-susceptibility-artifact">susceptibility artifact</a>-</li>-<li>-<strong>T1C+</strong>: no or variable contrast enhancement</li>-</ul><h4>Treatment and prognosis</h4><p>Treatment is usually surgical excision. There is a very low recurrence rate, and these tumours are not reported to have undergone malignant transformation <sup>3</sup>.</p><h4>Differential diagnosis</h4><ul>-<li>-<a href="/articles/tenosynovial-giant-cell-tumour">tenosynovial giant cell tumour</a>: will often show susceptibility artifact on GRE <sup>1</sup>-</li>-<li>-<a href="/articles/nodular-fasciitis">nodular fasciitis</a> <sup>2</sup>-</li>- +<li><p><strong>T1:</strong> low-to-iso signal</p></li>
- +<li><p><strong>T2:</strong> heterogeneous</p></li>
- +<li><p><strong>GRE:</strong> absent <a href="/articles/magnetic-susceptibility-artifact">susceptibility artifact</a></p></li>
- +<li><p><strong>T1 C+ (Gd):</strong> no or variable contrast enhancement</p></li>
- +</ul><h4>Treatment and prognosis</h4><p>Treatment is usually surgical excision. There is a very low recurrence rate and these tumours are not reported to have undergone malignant transformation <sup>3</sup>.</p><h4>Differential diagnosis</h4><ul>
- +<li><p><a href="/articles/tenosynovial-giant-cell-tumour">tenosynovial giant cell tumour</a>: will often show susceptibility artifact on GRE <sup>1</sup></p></li>
- +<li><p><a href="/articles/nodular-fasciitis">nodular fasciitis</a> <sup>2</sup></p></li>
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