Sakuda Tomohiko, Kubo Tadahiko, Shinomiya Rikuo, Furuta Taisuke, Adachi Nobuo
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan.
Medicine (Baltimore). 2020 Jul 10;99(28):e21116. doi: 10.1097/MD.0000000000021116.
Fibro-osseous pseudotumor of the digit is a rare benign lesion of subcutaneous tissue that typically arises in the parabone site of the proximal phalanx in young adult females. The lesion is histopathologically characterized by fibroblastic proliferation and osteoid formation. Good prognosis following complete surgical excision of the tumor has been reported, with a very low recurrence rate and no reports of malignant transformation. Despite its benign clinical behavior, the lesion can be mistaken for a malignant neoplasm, such as an extraskeletal or parosteal osteosarcoma, in case of rapid growth, thereby rendering the diagnosis challenging.
We report the case of a 30-year-old right-handed male who presented to our hospital with a rapidly growing mass on the dorsal aspect of the right little finger.
The patient was suspected to have soft tissue tumor of the little finger. The lesion could be considered a malignant tumor on the basis of clinical findings.
The patient underwent surgery for exploration and excision of the mass.
The excised mass was diagnosed to be fibro-osseous pseudotumor of the digit upon histological assessment. Postoperatively, the wound healed without complications. At postoperative 6 months, there were no signs or symptoms of recurrence, and the patient returned to his premorbid functional status.
Following the detection of a soft tissue mass with clinicopathological features of pseudomalignancy in the digit, clinicians should consider fibro-osseous pseudotumor of the digit as a possible diagnosis, thereby avoiding unnecessary aggressive surgery.
指部纤维骨性假瘤是一种罕见的皮下组织良性病变,通常发生于年轻成年女性近端指骨的旁骨部位。该病变在组织病理学上的特征为成纤维细胞增生和类骨质形成。据报道,肿瘤完整手术切除后预后良好,复发率极低,且无恶变报告。尽管其临床行为为良性,但在病变快速生长时,可能会被误诊为恶性肿瘤,如骨外或骨旁骨肉瘤,从而使诊断具有挑战性。
我们报告一例30岁右利手男性患者,因右手小指背侧肿物迅速增大前来我院就诊。
患者被怀疑患有小指软组织肿瘤。根据临床表现,该病变可被视为恶性肿瘤。
患者接受了肿物探查及切除术。
组织学评估显示,切除的肿物为指部纤维骨性假瘤。术后伤口愈合良好,无并发症。术后6个月,无复发迹象或症状,患者恢复至病前功能状态。
在发现指部具有假恶性临床病理特征的软组织肿物后,临床医生应考虑指部纤维骨性假瘤这一可能诊断,从而避免不必要的激进手术。