Aponeurotic fibroma explained

Synonyms:	Calcifying aponeurotic fibroma, juvenile aponeurotic fibroma

Aponeurotic fibroma, also known as calcifying aponeurotic fibroma, and juvenile aponeurotic fibroma is characterized by a lesion that usually presents as a painless, solitary, deep fibrous nodule, often adherent to tendon, fascia, or periosteum, on the hands and feet.^[1] The World Health Organization in 2020 reclassified aponeurotic fibroma nodules as a specific benign type of the fibroblastic and myofibroblastic tumors.^[2] Aponeurotic fibromas are diagnosed based on histopathology 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.^[3] 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.^[4]

Diagnosis

A histological examination is necessary to make a diagnosis.^[5] Histologically, the tumor is characterized by fibroblast growth and calcification.^[3]

Imaging results include edematous alterations and subcutaneous neoplastic tumors with hazy margins that appear to be encroaching on the surrounding tissues. The fascia and tendon sheath are next to the tumor. While T2WI displays heterogeneous signals, T1WI displays signals that are hypointense to isointense. Additionally, there is heterogeneous contrast enhancement.^{[6] [7] [8]}

Treatment

The treatment of choice for an aponeurotic fibroma is surgical excision.^[5]

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.^[4]

See also

• Skin lesion
• Fibromatosis

Further reading

• Fetsch . John F . Miettinen . Markku . Calcifying aponeurotic fibroma: A clinicopathologic study of 22 cases arising in uncommon sites . Human Pathology . Elsevier BV . 29 . 12 . 1998 . 0046-8177 . 10.1016/s0046-8177(98)90022-3 . 1504–1510 . none.
• Book: Mocellin, Simone . Soft Tissue Tumors . Calcifying Aponeurotic Fibroma . Springer International Publishing . Cham . 2021 . 151–152 . 978-3-030-58709-3 . 10.1007/978-3-030-58710-9_42 . none.

External links

• DermNet
• Pathology Outlines

Notes and References

1. Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). Page 989. McGraw-Hill. .
2. Sbaraglia M, Bellan E, Dei Tos AP . The 2020 WHO Classification of Soft Tissue Tumours: news and perspectives . Pathologica . 113 . 2 . 70–84 . April 2021 . 33179614 . 8167394 . 10.32074/1591-951X-213 .
3. Le . Keasbey . Juvenile aponeurotic fibroma (calcifying fibroma); a distinctive tumor arising in the palms and soles of young children . Cancer . 1953 . 6 . 2 . 338–346 . 0008-543X . 13032926 . 10.1002/1097-0142(195303)6:2<338::aid-cncr2820060218>3.0.co;2-m . 2024-04-17 .
4. Kim . Ok Hwa . Kim . Yeon Mee . Calcifying Aponeurotic Fibroma: Case Report with Radiographic and MR Features . Korean Journal of Radiology . The Korean Society of Radiology . 15 . 1 . 2014 . 134–139 . 1229-6929 . 10.3348/kjr.2014.15.1.134 . 24497803 . 3909846 .
5. Sekiguchi . Tomoya . Nakagawa . Motoo . Miwa . Shinji . Shiba . Ayano . Ozawa . Yoshiyuki . Shimohira . Masashi . Sakurai . Keita . Shibamoto . Yuta . Calcifying aponeurotic fibroma in a girl: MRI findings and their chronological changes . Radiology Case Reports . Elsevier BV . 12 . 3 . 2017 . 1930-0433 . 10.1016/j.radcr.2017.04.009 . 620–623. 5551990 .
6. Morii . Takeshi . Yoshiyama . Akira . Morioka . Hideo . Anazawa . Ukei . Mochizuki . Kazuo . Yabe . Hiroo . Clinical significance of magnetic resonance imaging in the preoperative differential diagnosis of calcifying aponeurotic fibroma . Journal of Orthopaedic Science . Elsevier BV . 13 . 3 . 2008 . 0949-2658 . 10.1007/s00776-008-1226-6 . 180–186.
7. NISHIO . JUN . INAMITSU . HIDEAKI . IWASAKI . HIROSHI . HAYASHI . HIROYUKI . NAITO . MASATOSHI . Calcifying aponeurotic fibroma of the finger in an elderly patient: CT and MRI findings with pathologic correlation . Experimental and Therapeutic Medicine . Spandidos Publications . 8 . 3 . 2014-07-11 . 1792-0981 . 10.3892/etm.2014.1838 . 841–843.
8. Takaku . Mitsuru . Hashimoto . Ichiro . Nakanishi . Hideki . Kurashiki . Taeko . Calcifying aponeurotic fibroma of the elbow: a case report . The Journal of Medical Investigation . University of Tokushima Faculty of Medicine . 58 . 1,2 . 2011 . 1343-1420 . 10.2152/jmi.58.159 . 159–162. 21372502 .