Arch Hand Microsurg.  2019 Sep;24(3):248-253. 10.12790/ahm.2019.24.3.248.

Calcifying Aponeurotic Fibroma in Dangerous Zone of Hand in Young Child

• Hong SW
• Choi HJ
• Kim JH
• Lee DW

• KMID: 2456249
• DOI: http://doi.org/10.12790/ahm.2019.24.3.248

Abstract

Pediatric hand masses are often seen in outpatient department of the hospital. There are kinds of masses that can occur and it is important to discriminate between malignant and benign, since the treatment may be different. Calcifying aponeurotic fibroma (CAF) is a rare benign soft tissue in children and adolescents. It primarily occurs on the distal portion of the extremities, typically fingers, palms of the hands and plantar aspects of the feet. The recommended treatment of CAF is conservative local excision. Considering its benign characteristics and the rare metastasis, a strong and enough efforts should be made, whenever possible, to preserve the function of involved extremities, especially in child. In our report, we present a case of a 4-year-old girl with a CAF found near the course of motor branch of ulnar nerve at the palm and being performed surgical removal successfully with preserving the nerves.

Keyword

Hand; Pediatrics; Neoplasms

MeSH Terms

Adolescent
Child*
Child, Preschool
Extremities
Female
Fibroma*
Fingers
Foot
Hand*
Humans
Neoplasm Metastasis
Outpatients
Pediatrics
Ulnar Nerve

Figure

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  Fig. 1. Preoperative image: slightly movable and poorly cir-cumscribed mass in the palm of her right hand.

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  Fig. 2. Ultrasonographic image: 0.5 cm sized isoechoic nodule.

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  Fig. 3. X-ray image: no specific findings and bony abnormality.

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  Fig. 4. Intraoperative image: a yellowish 15×10 mm mass with areas of speckled calcification.

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  Fig. 5. Histopathologic images. (A) The tumor exhibited infiltrative growth pattern, extending the surrounding soft tissue (H&E stain, ×4). (B) There were multifocal area of calcification in the tumor (H&E stain, ×400). (C) The tumor was composed of benign spindle cells with round to ovoid nuclei and eosinophilic cytoplasms (H&E stain, ×40).

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  Fig. 6. Postoperative image: 2 years after the operation, there is asymptomatic and no signs of recurrence.

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