Korean J Radiol.  2013 Dec;14(6):963-967. 10.3348/kjr.2013.14.6.963.

Desmoplastic Fibroma of Bone in a Toe: Radiographic and MRI Findings

• Kim OH
• Kim SJ
• Kim JY
• Ryu JH
• Choo HJ
• Lee SJ
• Lee IS
• Suh KJ

• KMID: 1711465
• DOI: http://doi.org/10.3348/kjr.2013.14.6.963

Abstract

Desmoplastic fibroma is a rare benign primary bone tumor that is histologically similar to the soft tissue desmoid tumor. It most often involves the mandible, large long bone or iliac bone. Desmoplastic fibroma in a toe has been extremely rarely reported. Authors report a rare case of desmoplastic fibroma of bone occurring in the distal phalanx of a foot, with descriptions of the radiographic and MRI findings, correlation of the radiologic and pathologic findings, and discussion on the differential diagnosis of the tumor.

Keyword

Desmoplastic fibroma; Bone tumor; Toe; Magnetic resonance imaging

MeSH Terms

Adolescent
Bone Neoplasms/*diagnosis
Diagnosis, Differential
Female
Fibroma, Desmoplastic/*diagnosis
Humans
Magnetic Resonance Imaging
Male
Toes/*pathology

Figure

• 

  Fig. 1 Fourteen-year-old male with desmoplastic fibroma in first toe. A, B. Fourteen-year-old male with intermittent painful swelling in his first toe. Anterior-posterior (A) and lateral (B) radiographs of forefoot demonstrate well-demarcated, sclerotic margined, oval, osteolytic lesion with dorsal cortical thinning and breakthrough (arrowhead) in distal phalanx of first toe. Associated pathologic fracture through distal portion of osteolytic lesion is demonstrated (arrow). There is no demonstrable matrix mineralization within tumor. C-F. MRI of desmoplastic fibroma of bone in first toe. Small ovoid central area of well-defined, osteolytic lesion shows hypointensity on all MR sequences (arrow in C-E), including axial T1WI (C), coronal T2WI (D), and sagittal STIR image (E), and shows little enhancement on sagittal fat-suppressed T1WI after gadolinium administration (F). Peripheral area of mass shows heterogeneous high signal intensity on T2WI and STIR images, and heterogeneous high to little contrast enhancement on fat-suppressed T1WI after gadolinium administration. Dorsal cortical breakthrough with small soft tissue extension (arrowheads in C, E, F) is demonstrated. T1WI = T1-weighted image, STIR = short tau inversion recovery. G, H. Photomicrographs of desmoplastic fibroma of bone. At low-power view (G), tumor displayed central hypocellular area (arrows) surrounded by peripheral cellular area (arrowheads) (hematoxylin and eosin stain, × 40). At high power view (H), peripheral area of tumor is composed of bland spindle cells with characteristic fascicular arrangement (arrows) (hematoxylin and eosin stain, × 200).

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