Fibroma of the tendon sheath of the long head of the biceps tendon

Abstract

Fibroma of the tendon sheath is a benign tumor that is less common than giant cell tumor of the tendon sheath. Both tumors may present as a painless, slowly enlarging mass. Radiological findings may be similar for both tumors. Histologically, fibroma of the tendon sheath lacks the hemosiderin-laden macrophages that are typical for giant cell tumor of the tendon sheath. We report on a 49-year-old woman with fibroma of the tendon sheath of the long head of the biceps tendon. In our case, on MR images, we observed band-like hypointense areas centrally in the tumor, mild patchy contrast enhancement, and most importantly, no decrease of signal intensity on gradient echo images. These characteristics reflected histological findings.

Fibroma of tendon sheath around large joints: clinical characteristics and literature review

“…Although it is rare, a joint effusion and locking appear in a few cases [ 10 , 16 , 19 ]. In 3 extra-articular FTSs arising around a large joint, the symptom was often pain with joint motion [ 6 , 17 , 24 ], and they rarely showed radiating pain due to irritating tissue surrounding the tumor, for example the nerve, as in the present Case 1.…”

“…These findings presented that the tumor contained central areas of increased cellularity and myxoid change on a background of slit-like vascular [ 35 ].Various types of gadolinium-enhanced MRI findings are seen from case to case. The patterns of enhancement are reported as rim/peripheral [ 11 , 15 , 17 , 18 ], patchy or focal in the mass [ 6 , 21 , 24 ], and lobular enhancement (present Case 3). Takakubo et al [ 15 ] described peripheral enhancement that may reflect blood vessel proliferation at the periphery of the tumor.…”

“…T2-weighted images showed various patterns, most commonly low signal intensity to muscle in 8 of 43 reviewed cases [6, 13, 22, 23, 26, present cases 1 and 3], a central high intensity signal in a low intensity area and a focally high intensity signal in a low area in 5 cases [12, 16, 19, 27, present Case 2], and a high intensity signal was seen in 4 reports [ 11 , 18 , 20 , 25 ]. A few cases showed a heterogeneous low or high-intensity mass or mixed high and low signals [ 6 , 15 , 17 , 21 , 24 ].…”

“…MRI findings of GCTTS typically show a solid soft tissue mass with a round, oval, or multilobular shape near or inside the joint and present low signal intensity on both T1- and T2-weighted images, similar to FTS [ 37 ]. Contrast enhancement on MRI is variable for both FTS and GCTTS [ 24 ]. Although contrast enhancement is usually more prominent in GCTTS, FTS show lack of contrast enhancement or mild enhancement [ 24 ].…”

“…Contrast enhancement on MRI is variable for both FTS and GCTTS [ 24 ]. Although contrast enhancement is usually more prominent in GCTTS, FTS show lack of contrast enhancement or mild enhancement [ 24 ]. Histopathological features of GCTTS are characterized by the existence of multinucleated giant cells and hemosiderin deposits, as this point is important for differential diagnosis [ 5 ].…”