Calcifying Aponeurotic Fibroma of the Dorsum of the Foot in a Four-Year-Old Boy: A Case Report With Radiographic and Magnetic Resonance Findings

Abstract

Calcifying aponeurotic fibroma (CAF) is a rare, benign fibroblastic tumor that typically occurs in the palms of the hands and soles of the feet, in children and adolescents. Due to its infiltrative nature, this tumor can mimic malignancy on preoperative magnetic resonance imaging (MRI) and has a predilection for local recurrence. There are very few reports in the literature that describe features of CAF on MRI, especially those arising in the foot. We present an unusual case of a CAF affecting the dorsum of the foot in a four-year-old boy.

MRI features of calcifying aponeurotic fibroma in the upper arm: a case report and review of the literature

“…In one case report, the specific MRI sequence was not described; we reviewed the remaining 11 reports, including 9 case reports, 1 case series that included 6 patients, and a case contained in a pictorial essay [2][3][4][5][6][7][8][9][10][11][12]. Table 1 summarizes the patient characteristics and clinical findings of these 11 previous reports.…”

“…In addition, less frequently involved sites include the neck, thigh, forearm, popliteal fossa, and lumbosacral region [2]. Only a limited number of published studies describe the magnetic resonance imaging (MRI) features of calcifying aponeurotic fibroma of the upper or lower extremities [2][3][4][5][6][7][8][9][10][11][12][13]. We here report the atypical MRI findings of calcifying aponeurotic fibroma in a 23-year-old female who presented with an intermuscular mass affecting her left upper arm.…”

The Nonage Concretion-Calcifying Aponeurotic Fibroma

“…On plain radiography, calcifying aponeurotic fibroma exhibits a soft tissue mass with foci of fine or coarse calcification. Bony incrimination appears as periosteal reaction or defect in the cortical bone [7,8]. Computerized tomography (CT) is advantageous in visualizing tumour associated calcification [7].…”

Calcifying aponeurotic fibroma

“…A lesão não é facilmente identificada nas radiografias. A avaliação complementar mais recomendada para diagnóstico e planejamento pré-operatório é a ressonância magnética (RM), que permite avaliar a extensão as margens da lesão, e a complexidade das calcificações (1,7,8) .…”

“…Diagnósticos diferenciais do FAC são o sarcoma sinovial, sarcoma pleomórfico indiferenciado, principalmente nas mãos e punhos (9) , sarcoma epitelioide, sarcoma de células claras, tumor de células gigantes da bainha do tendão, condroma de partes moles, fibromatose palmar ou plantar, neuroma de Morton e tumor da bainha de nervo periférico (Schwanoma). O tratamento recomendado é a excisão cirúrgica completa com margem oncológica (6,7) , seguida de análise histológica e estudo imunohistoquímico (8) . Devido ao padrão localmente invasivo, o FAC apresenta altas taxas de recorrência após a excisão cirúrgica (1,3,5) .…”