Fibro-Osseous Pseudotumor of the Digits is an uncommon and benign soft tissue tumor. As the name suggests, it presents as a rapidly growing mass on the hands and feet ranging in size from 1-3 cm. The overlying skin may show reddening and there may be pain. If it occurs on the hands, the volar or sides of the fingers are most common, usually at the metacarpals and phalanges.
SYNONYMS Florid reactive periostitis
INCIDENCE Rare AGE RANGE-MEDIAN 5-70 years
Mean 34 years
PATHOGENESIS CHARACTERIZATION Probably a reactive lesion-often a history of trauma Shares many overlapping traits with myositis ossificans, another reactive condition of soft tissue
LABORATORY/RADIOLOGIC/OTHER TESTS CHARACTERIZATION Radiographs
Soft tissue swelling or density with irregular calcifications
May have periosteal reactions such as lamellatins or Codman's triangle
Occasionally cortical erosion and bony destruction
GROSS APPEARANCE/CLINICAL VARIANTS CHARACTERIZATION General White-gray firm mass associated with calcifications but no hemorrhage or necrosis
HISTOLOGICAL TYPES CHARACTERIZATION General
Osteoid and bone usually prominent and distributed haphazardly but occasionally in a zonation pattern like myositis ossificans
Poor correlation between histologic changes and age of the lesion
DIFFERENTIAL DIAGNOSIS KEY DIFFERENTIATING FEATURES Paraosteal, periosteal, high grade surface and extraskeletal osteosarcoma High grade cytologic appearance of the cells Nora's lesion (Bizzare paraosteal osteochondromatous proliferation) Prominent cartilaginous component
Zonal pattern of peripheral mature bone with central cellular areas
Present in skeletal muscle
Inflammation and hemorrhage
Ostechondroma Cartilaginous cap surfacing organized bony trabeculae Calcifying aponeurotic fibroma Highly collagenized fibroblastic proliferation with bands of calcification arising from hyalinzed fibrous tissue
PROGNOSIS AND TREATMENT CHARACTERIZATION Prognostic Factors May have local recurrence Metastasis None reported Treatment Local excision
Am J Surg Pathol 1981;5:423-433.
Soft tissue tumors
Last Updated 4/1/2001
Send mail to The Doctor's Doctor with questions or comments about this web site.
Copyright © 2004 The Doctor's Doctor