Fibroosseous Pseudotumor



Fibroosseous Pseudotumor


David R. Lucas, MD









Fibroosseous pseudotumor (FP) typically presents as fusiform swelling in a proximal phalanx of the hand. This radiograph depicts ill-defined soft tissue density image and periosteal reaction image.






Microscopically, FP consists of a fasciitis-like proliferation of myofibroblasts image admixed with osteoid and reactive bone image. FP is regarded as a reactive nonneoplastic process.


TERMINOLOGY


Abbreviations



  • Fibroosseous pseudotumor (FP)


Synonyms



  • Florid reactive periostitis of tubular bones of hands and feet


  • Fasciitis ossificans


  • Panniculitis ossificans


  • Parosteal fasciitis


  • Pseudomalignant osseous tumor of soft tissues


Definitions



  • Benign reactive ossifying fibroblastic proliferation most often affecting skin and soft tissue in digits of hands and feet


ETIOLOGY/PATHOGENESIS


Reparative Reaction



  • Trauma


  • Repetitive injury


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Rare, exact incidence unknown


  • Age



    • 5-75 years; median: ≈ 35 years


  • Gender



    • Slight female predominance


Site



  • Hands and feet



    • Proximal phalanx of hand most common site


    • Rarely occurs beyond acral extremities


Presentation



  • Fusiform swelling, often with erythema, pain, or ulceration


  • Rapid onset, weeks to months


Natural History



  • Benign, may be self-limited


Treatment



  • Surgical approaches



    • Simple excision usually curative


Prognosis



  • Excellent, rarely recurs


IMAGE FINDINGS


General Features



  • Early lesions characterized by ill-defined soft tissue density


  • Older lesions with intralesional calcification


  • Periosteal reaction common


MACROSCOPIC FEATURES


Size



  • 0.5-5.6 cm; median: ≈ 2 cm


MICROSCOPIC PATHOLOGY


Histologic Features

Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Fibroosseous Pseudotumor
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