Ajarrag Samy, Torchon Marie-Christine
Programme de Médecine Podiatrique, Université du Québec à Trois-Rivières, 3351 Bd des Forges, Trois-Rivières, QC, G8Z 4M3, Canada.
BMC Musculoskelet Disord. 2025 Feb 1;26(1):98. doi: 10.1186/s12891-025-08340-5.
Desmoplastic fibroma is a rare, benign bone tumor that exhibits locally aggressive behavior and typically occurs in the mandible and long bones. Its presence in small bones, particularly in the hallux, is exceedingly rare. Desmoplastic fibroma's unusual presentation in this region often mimics other lesions, such as glomus tumors, and poses significant diagnostic challenges.
We present the case of a 38-year-old female with a history of trauma to the affected toe and thyroid cancer, who experienced persistent subungual pain, localized tenderness, and cold hypersensitivity in the hallux. Initial imaging (X-ray and MRI) revealed findings consistent with a glomus tumor, including bone erosion in the distal phalanx. Surgical excision with wide margins was performed due to the patient's cancer history, and histopathology unexpectedly identified the lesion as desmoplastic fibroma. The patient underwent regular follow-up with X-rays over two years, showing complete healing and no recurrence.
The case emphasizes the necessity of sending excised specimens for pathological analysis to confirm the diagnosis. Documenting such atypical presentations contributes valuable information to the limited literature on desmoplastic fibroma and aids clinicians in recognizing this rare tumor in unusual locations, potentially improving diagnostic accuracy and management.
促结缔组织增生性纤维瘤是一种罕见的良性骨肿瘤，具有局部侵袭性，通常发生在下颌骨和长骨。它在小骨中出现，尤其是在拇趾，极为罕见。促结缔组织增生性纤维瘤在该区域的不寻常表现常类似于其他病变，如血管球瘤，带来重大的诊断挑战。
我们报告一例38岁女性病例，该患者有患趾外伤史和甲状腺癌病史，其拇趾出现持续的甲下疼痛、局部压痛和冷过敏。初始影像学检查（X线和MRI）显示结果与血管球瘤一致，包括远节指骨骨质侵蚀。由于患者有癌症病史，遂行广泛边缘切除手术，组织病理学检查意外发现该病变为促结缔组织增生性纤维瘤。患者在两年内接受了定期X线随访，显示完全愈合且无复发。
该病例强调了将切除标本送检进行病理分析以确诊的必要性。记录此类非典型表现为关于促结缔组织增生性纤维瘤的有限文献提供了有价值的信息，并有助于临床医生在不寻常部位识别这种罕见肿瘤，可能提高诊断准确性和治疗效果。
