Fibro-osseous pseudotumor that may be mistaken for a malignant tumor in the hand: A case report and review of the literature

Fibro-Osseous Pseudotumor of the Digits: A Rare Tumor in an Unusual Location

“…Pain, tenderness, and functional limitation may be present. [1][2][3][4][5][6] In about one third of the cases, a history of trauma is present, but in our case there was no history of trauma. 1,10 Fibro-osseous pseudotumor of the digits chiefly affects young adults, with a slight predominance in women.…”

“…A review of 50 cases of MO and 14 cases of FOPT showed that a malignant diagnosis was suggested by referring pathologists in 23% of MO and 9% of FOPT cases. [1][2][3]6 The recommended treatment for FOPT is local excision, and, as previous studies also reported, the prognosis is excellent. Dupree and Enzinger reported only 1 recurrence in 7 patients with several months to 15 years of follow-up data.…”

“…6 Other than these two large series of FOPT cases, we found only a few case reports, which also involved 1 finger of each of the patients. [2][3][4][5]10 The proximal phalanx region is more often involved than is the distal; the metacarpal region of the hand is rarely affected. [1][2][3][4][5][6]10 In our case, the tumor originated from the wrist's first dorsal-extensor compartment, which is a tenosynovial structure that mimics the digital tenosynovial tunnel.…”

“…6 They reported that the correct clinical diagnosis was not made in 2 cases, and unnecessary amputation of the digit was performed in these cases. 1,3 In another case report, ray amputation was performed because of the lesion's rapid progression. 5 Dupree and Enzinger reported 6 cases misdiagnosed as extraskeletal or parosteal osteosarcoma.…”

Periosteal reactive change of the proximal phalanx of the foot

“…Non-neoplastic reactive changes accompanied by bone formation such as FRP and BPOP in small tubular bones of hand or foot are rare but increasingly frequently observed conditions (Craver et al 1997, de Lange et al 1987a, Howard et al 1996, Holmes et al 1987, Nance et al 1990, Nora et al 1983, Riaz et al 1996, Rogers & Brzezienski 1999, Spjut & Dorfman 1981. So far many synonyms such as myositis ossificans, parosteal fasciitis, pseudosarcomatous fibromatosis, and fasciitis ossificans, FRP, BPOP have been used to describe these entities (Dupree & Enzinger 1986, Nora et al 1983, Spjut & Dorfman 1981, Tang et al 1996. Although the diagnostics may be somewhat different depending on the authors, all diagnoses have in common the involvement of only the extracortical, but not the intramedullary or cortical area.…”