Calcifying Aponeurotic Fibroma of the Hand: Radiologic Differentiation from Giant Cell Tumors of the Tendon Sheath

Parker, Wendy L.; Beckenbaugh, Robert R.; Amrami, Kimberly K.

doi:10.1016/j.jhsa.2006.04.011

Cited by 18 publications

(15 citation statements)

References 14 publications

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“…However, on a T2-weighted image, some authors demonstrated that CAF showed low signal intensity, while others reported that CAF exhibited homogeneously or heterogeneously high signal intensity (9). This variability of signal intensity on the T2-weighted image is thought to depend on the degree of hypocellularity or the amount of calcification or collagen within the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Many authors who reported CAF included hemangioma, fibroma or fibromatosis, localized tenosynovial giant-cell tumor (GCT), soft-tissue chondroma, and less commonly soft-tissue sarcoma such as synovial sarcoma in differential diagnosis (9,10). Especially, localized tenosynovial GCT is associated intimately with the tendon sheath and may erode bone.…”

Section: Discussionmentioning

confidence: 99%

“…It has relatively characteristic MRI finding with well-defined, lobulated margins, uniform enhancement, heterogeneous hypointense signals associated with hemosiderin deposition and pressure erosion, but very rare calcifications. Also, it rarely occurs in children (9,10). A soft-tissue chondroma has a well-defined, lobulated, and diffuse calcification.…”

Section: Discussionmentioning

confidence: 99%

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Calcifying Aponeurotic Fibroma of the Knee: a Case Report with Radiographic and MRI Finding

Lee

Song

et al. 2017

Investig Magn Reson Imaging

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Calcifying aponeurotic fibroma (CAF) is an uncommon benign tumor and a locally aggressive fibroblastic lesion. It commonly affects the palmar side of the hand and fingers, and the soles of the feet. The typical clinical manifestations are known as a poorly circumscribed, slow-growing, and asymptomatic firm mass. Most CAFs usually reveal low to intermediate or isointensity on T1-weighted images, and strong heterogeneous enhancement. However, various signal intensities on T2-weighted images have been reported depending on the degree of hypocellularity or the amount of calcification or collagen within the tumor. This report provides the radiographic and MRI finding of CAF arising in uncommon site, the knee region, of a 19-year-old male who presented with a painful and palpable mass.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Calcifying Aponeurotic Fibroma of the Knee: a Case Report with Radiographic and MRI Finding

Lee

Song

et al. 2017

Investig Magn Reson Imaging

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“…In one case report, the specific MRI sequence was not described; we reviewed the remaining 11 reports, including 9 case reports, 1 case series that included 6 patients, and a case contained in a pictorial essay [2][3][4][5][6][7][8][9][10][11][12]. Table 1 summarizes the patient characteristics and clinical findings of these 11 previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, less frequently involved sites include the neck, thigh, forearm, popliteal fossa, and lumbosacral region [2]. Only a limited number of published studies describe the magnetic resonance imaging (MRI) features of calcifying aponeurotic fibroma of the upper or lower extremities [2][3][4][5][6][7][8][9][10][11][12][13]. We here report the atypical MRI findings of calcifying aponeurotic fibroma in a 23-year-old female who presented with an intermuscular mass affecting her left upper arm.…”

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confidence: 95%

MRI features of calcifying aponeurotic fibroma in the upper arm: a case report and review of the literature

et al. 2016

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Calcifying aponeurotic fibroma is a rare soft tissue tumor that occurs in the distal extremities of children and adolescents. We report a case of pathologically proven calcifying aponeurotic fibroma in the left upper arm of a 23-year-old female. Radiographs revealed increased soft tissue density with multiple stippled calcifications in the mid-portion of the patient's left upper arm. Magnetic resonance imaging (MRI) showed a well-defined soft tissue mass with low to intermediate signal intensity on T1-weighted images, heterogeneously low signal intensity on T2-weighted images, and heterogeneous enhancement on fat-suppressed, contrast-enhanced T1-weighted images. Histologically, spindle cell proliferation with scattered calcifications and hyalinization was present. Seven years after surgery, there was no evidence of local recurrence. This is the first report of MRI findings of calcifying aponeurotic fibroma in the upper arm. We also summarize the MRI findings of 16 previously reported cases of calcifying aponeurotic fibroma originating in the upper or lower extremities.

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Ultrasound and Magnetic Resonance Imaging Features of Calcifying Aponeurotic Fibromas

Kang

Lee

Yoo

et al. 2020

J of Ultrasound Medicine

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ObjectivesTo report characteristic imaging findings of calcifying aponeurotic fibromas (CAFs) on ultrasound (US) and magnetic resonance imaging (MRI).MethodsEight patients with CAF based on our institutional pathology database from 2000 to 2019 were consecutively included. Images were assessed as follows: with plain radiographs for the presence of soft tissue calcifications; with US for the presence of microlithiasis (a nonshadowing hyperechoic focus <3 mm) and discrete calcifications, size, location, margin, echogenicity, and relationship with surrounding structures; and with MRI for the presence of MRI microlithiasis (scattered tiny signal‐void dots), margin, signal intensity, contrast enhancement pattern, and relationship with surrounding structures.ResultsCalcifying aponeurotic fibromas occurred most commonly in the foot (n = 5), followed by the hand, ankle, and knee, respectively. Half of the lesions (n = 4) showed intralesional calcifications on plain radiographs. On US, all lesions showed microlithiasis. They involved the subcutaneous (n = 5), perifascial (n = 2), and intermuscular (n = 1) layers. Margins were circumscribed (n = 3) or irregular (n = 5), whereas the echogenicity of the underlying tumor matrix was hyperechoic (n = 4), isoechoic (n = 2), or hypoechoic (n = 2). All lesions were abutting (n = 7) or encasing (n = 1) an adjacent tendon. On MRI, all CAFs showed tiny signal‐void dots and irregular margins. Signal intensity was mostly hyperintense (n = 5) on T2‐weighted images and all hypointense on T1‐weighted images. Three lesions showed heterogeneous contrast enhancement, and 3 showed uneven marginal enhancement.ConclusionsA CAF should be considered a differential diagnosis if a soft tissue mass abutting or encasing the tendon or fascia shows US or MRI microlithiasis.

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Calcifying Aponeurotic Fibroma of the Hand: Radiologic Differentiation from Giant Cell Tumors of the Tendon Sheath

Cited by 18 publications

References 14 publications

Calcifying Aponeurotic Fibroma of the Knee: a Case Report with Radiographic and MRI Finding

Calcifying Aponeurotic Fibroma of the Knee: a Case Report with Radiographic and MRI Finding

MRI features of calcifying aponeurotic fibroma in the upper arm: a case report and review of the literature

Ultrasound and Magnetic Resonance Imaging Features of Calcifying Aponeurotic Fibromas

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