Alaboudi Abdullah S, Alrawi Mustafa, AlShaya Osama, AlAbbasi Khaled
Orthopaedic Surgery, King Fahad Medical City, Riyadh, SAU.
Cureus. 2025 Feb 15;17(2):e79050. doi: 10.7759/cureus.79050. eCollection 2025 Feb.
Desmoplastic fibroma (DF) is a rare, benign, yet locally aggressive bone tumor, typically affecting long bones in young individuals. Its occurrence in the ulna is extremely rare. This case report highlights the diagnostic challenges of a 16-year-old female presenting with DF of the ulna. The report emphasizes individualized treatment and long-term follow-up and raises awareness of DF in atypical locations. This patient presented with a two-month history of mild, activity-related pain in the distal forearm. Imaging revealed an expansile lytic lesion in the distal ulna, characterized by cortical thinning and breaches, consistent with desmoplastic fibroma (DF). Routine blood tests were normal, and histopathology confirmed spindle fibroblasts in a collagenous stroma with dilated vascular channels, confirming DF. The patient underwent intralesional curettage, bioceramic cement application, and plate and screw fixation. Postoperatively, she experienced mild surgical site pain but retained full wrist motion and grip strength. At six months, the patient showed no recurrence and good functional outcomes. This case highlights the rarity of desmoplastic fibroma in the ulna, emphasizing the challenges of diagnosis and management. Accurate diagnosis through imaging and histopathology, combined with individualized surgical treatment, preserved function and prevented reoccurrence. It underscores the need for long-term follow-up to ensure successful outcomes and adds valuable insight to the limited literature on this condition.
促结缔组织增生性纤维瘤(DF)是一种罕见的良性但具有局部侵袭性的骨肿瘤,通常影响年轻个体的长骨。其发生于尺骨极为罕见。本病例报告强调了一名患有尺骨DF的16岁女性的诊断挑战。该报告强调个体化治疗和长期随访,并提高对非典型部位DF的认识。该患者有两个月的前臂远端轻度、与活动相关疼痛的病史。影像学检查显示尺骨远端有一个膨胀性溶骨性病变,其特征为皮质变薄和破坏,符合促结缔组织增生性纤维瘤(DF)。常规血液检查正常,组织病理学证实胶原基质中有梭形成纤维细胞,伴有扩张的血管通道,确诊为DF。患者接受了病灶内刮除、生物陶瓷骨水泥植入以及钢板螺钉固定。术后,她经历了轻度手术部位疼痛,但保留了完整的腕关节活动度和握力。六个月时,患者无复发且功能预后良好。本病例突出了尺骨促结缔组织增生性纤维瘤的罕见性,强调了诊断和管理的挑战。通过影像学和组织病理学进行准确诊断,结合个体化手术治疗,保留了功能并预防了复发。它强调了长期随访以确保成功结果的必要性,并为关于这种情况的有限文献增添了有价值的见解。