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Case Reports
. 2014 Jan-Feb;15(1):134-9.
doi: 10.3348/kjr.2014.15.1.134. Epub 2014 Jan 8.

Calcifying aponeurotic fibroma: case report with radiographic and MR features

Ok Hwa Kim  1 , Yeon Mee Kim  2
Affiliations
Case Reports

Calcifying aponeurotic fibroma: case report with radiographic and MR features

Ok Hwa Kim et al. Korean J Radiol. 2014 Jan-Feb.

Abstract

Calcifying aponeurotic fibroma is a rare, benign fibroblastic tumor. The lesion has a propensity for local invasion and a high recurrent rate. Therefore, accurate preoperative diagnosis and complete excision are important to prevent the recurrence of the tumor after surgical removal. However, radiographic and magnetic resonance imaging findings of calcifying aponeurotic fibroma have been extremely rarely described in the radiology literature. Thus, we report a rare case of calcifying aponeurotic fibroma affecting the dorsal wrist in a 67-year-old man, describe radiographic and MR findings, and discuss the differential diagnosis of the tumor.

Keywords: Calcifying aponeurotic fibroma; Magnetic resonance imaging; Soft tissue tumor; Wrist.

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Figures

Fig. 1
Fig. 1
Calcifying aponeurotic fibroma of dorsal wrist in 67-year-old man. AP (A), oblique (B) and lateral (C) radiographs of wrist demonstrate relatively ill-defined heterogeneously calcified soft tissue mass with extrinsic erosions (arrowheads in B) of adjacent carpal bones on dorsal ulnar aspect of wrist. Axial MR images (D-F) demonstrate ill-defined subcutaneous soft tissue mass, showing low to intermediate signal intensity on T1WI (D), heterogeneous mixture of low and high signal intensity on T2WI (E) and heterogeneously intense contrast enhancements on fat suppressed T1WI after intravenous gadolinium administration (F). Note that mass abuts tendons of extensor carpi ulnaris (short arrows in D-F) and extensor digiti minimi (arrows in D-F), erodes underlying carpal bones (arrowheads in D), and is associated with diffuse edema like signal changes in adjacent soft tissues of wrist. Photomicrograph (G) reveals scattered foci of calcification (white stars) and chondroid differentiation (asterisks) surrounded by peripheral less cellular, spindled fibroblastic component (arrows) between coalescent calcified and chondroid nodules (H&E stain, × 200). T1WI = T1-weighted image, T2WI = T2-weighted image
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