Ultrasonography of fibroma of the tendon sheath in the hand and wrist

Abstract

Background The purpose of our study was to explore the sonographic characteristics of fibromas of the tendon sheath of the hand and wrist and to evaluate the value of high frequency ultrasound in the diagnosis of FTS. Methods We retrospectively reviewed the sonography of 42 patients with surgically proven FTS, including one with a relapsing tumor (43 lesions in total). The location, size, distribution, relationship with the surrounding tissue, two-dimensional gray-scale sonographic appearance and internal color blood flow of all lesions were analysed. Results The maximum diameter ranged from 0.4 to 2.8 cm, with an average of 1.5 ± 0.6 cm. Twenty-eight lesions (65%) were associated with an adjacent tendon, while the other 15 lesions (35%) were next to the joint. Spindle or oval lesions were common, followed by irregular shape. The nodules with clear boundaries were hypoechoic and had posterior echo enhancement. Thirty-seven lesions (86%) were homogeneous, while 6 lesions (14%) had cystic components with no echo inside. Seventeen lesions (40%) had a large amount of blood flow. Nine lesions (20%) had a small amount of blood flow. The other 17 lesions (40%) had no significant blood flow. Conclusions The diagnosis of fibroma of the tendon sheath can be considered when ultrasound examination reveals a focal nodular mass adjacent to a tendon sheath with homogeneous hypoechogenicity and no or small or large amounts of blood flow.

Comparison of clinical and pathological characteristics between localized giant cell and fibroadenoma of tendon sheath

“…In our cases, the two cases have slightly different common sites (L-GCTS is more common in the right hand, while FTS is more common in the left hand but the difference is not signi cant). Preoperative imaging examinations such as ultrasound, X-ray and MRI sometimes make it di cult to make a clear diagnosis of both [20,21].…”

Benign Tumors of the Wrist, Hand, and Fingers

“…In those patients not exhibiting pain, limitation of function, or voicing cosmetic concerns, careful observation is considered an appropriate treatment option. For those patients presenting with symptomatic fibromas or for whom a concern for a malignant lesion is evident, surgical excision is the most suitable choice of care 6,[13][14][15] .…”

“…FTS occurs most commonly in the hand and wrist region but can occur in other parts of the extremities. Fibromas primarily occur in adults in the 30 to 50-year-age range and affect men more often than women 13,14 . Fibromas can be found in children, but this is rare.…”

“…Fibroma of the tendon sheath (FTS), also referred to as a synovial tendon sheath fibroma, is a rare benign tumor composed of spindle cells and collagen fibers 1,13,14 . FTS occurs most commonly in the hand and wrist region but can occur in other parts of the extremities.…”