Symptomatic plantar fibroma with a unique sonographic appearance

Abstract

We present a case of a solitary plantar fibroma with unique sonographic features with MRI and pathologic correlation. A 25-year-old woman presented with a left foot mass that interfered with her gait. Sonography demonstrated a well-circumscribed, 32 mm × 27 mm × 14 mm subcutaneous mass with heterogeneous echogenicity. Unique sonographic characteristics included posterior acoustic enhancement, cystic components, and mild intratumoral hypervascularity. MRI confirmed the sonographic findings. Surgical excision was performed without complication. A pathologic diagnosis of fibroma with myxoid degeneration and cyst formation was made.

Ultrasonography of Plantar Fibromatosis: Updated Case Series, Review of the Literature, and a Novel Descriptive Appearance Termed the “Comb Sign”

“…Intrinsic vascularity was seen in 53% of patients, which was in contrast to the most recent large cohort which showed vascularity in only 8% of lesions . Vascularity was not graded in the study by Griffith et al, but our cohort showed 20% of lesions with moderate and marked vascularity, compatible with a prior report that lesions may have substantial increased intrinsic vascularity . The presence of vascularity in our series may be reflective of newer US technology being more sensitive.…”

“…8 Vascularity was not graded in the study by Griffith et al, 8 but our cohort showed 20% of lesions with moderate and marked vascularity, compatible with a prior report that lesions may have substantial increased intrinsic vascularity. 20 The presence of vascularity in our series may be reflective of newer US technology being more sensitive. Concordant with nearly all prior studies, calcifications and cystic changes were not seen in the cohort.…”

Imaging Features of Superficial and Deep Fibromatoses in the Adult Population

“…Plantar fibroma may be heterogeneous and hypoechoic (76%) or isoechoic (24%) relative to the plantar fascia [3, 28]. Posterior acoustic enhancement (20%), cystic components, and intratumoral hypervascularity (8%) have also been described [28, 29]. …”

Clinics in diagnostic imaging (195)

“…Small intranodular cystic components causing posterior acoustic enhancement may also be present; Haun et al in 2011 reported a case of plantar fibroma that showed myxoid stromal degeneration and cysts histologically. (9) Sonoelastography is useful as a supplementary technique in musculoskeletal imaging. It provides qualitative information about the relative elasticities of soft tissues by measuring how they respond to applied stresses, using either shear-wave propagation or strain application (i.e.…”