Ultrasound and Magnetic Resonance Imaging Features of Calcifying Aponeurotic Fibromas

Calcifying Aponeurotic Fibroma of Leg Masquerading as Hemangioma in an Adolescent Male along with Review of Literature

Calcifying aponeurotic fibroma (CAF) is a rare soft tissue tumor which falls under the WHO category of benign fibroblastic and myofibroblastic tumors. It typically occurs on the distal extremities (hands and foot) of children and adolescents. Other less common sites include wrists, ankles, trunk and rarely legs and arms. These tumors present as a painless soft tissue mass, arising in the subcutis, and are usually connected to tendons or aponeuroses. Computed tomography (CT) and magnetic resonance imaging (MRI) are the radiological investigations of choice; however, histopathology remains the diagnostic modality of choice for the diagnosis of CAF. We present a rare case of a 17-year-old boy who presented with a gradually progressive mass lesion on the leg which was later diagnosed as calcifying aponeurotic fibroma on histopathology.

MRI/fluorescence dual-mode probe: its simple preparation method and imaging application in vitro

Superparamagnetic nanoparticles have been widely used as contrast agents in magnetic resonance imaging (MRI). The combined use of multiple imaging modes can provide more accurate information for clinical diagnosis. In this paper, a MRI/fluorescence dual-mode imaging contrast agent was developed by a simple method. The method is to make the fluorescent carbon quantum dots (CDs) adsorbed on the surface of the magnetic composite with pore structure by ultrasonic dispersion. Replacing the traditional methods such as chemical bonding, the fluorescent material is coated on the surface of the composite material. The synthesized composite materials were characterized by the transmission electron microscopy method (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and vibration sample magnetometer (VSM). The results of TEM, FTIR and XPS showed that CDs were successfully coated on the surface of C60@Fe3O4 magnetic composite. The VSM results show that the composite material still maintains superparamagnetism. The cytotoxicity of the material on SMMC-7721 liver cancer cells was detected by the MTT method, and the biocompatibility of the material was verified. By observing the fluorescence distribution in the cell, it is proved that the composite material successfully enters the cell and produces fluorescence. Finally, through the analysis of T2-weighted imaging, it is found that the addition of materials results in an enhanced dark contrast compared to control cells. Therefore, the composite nanomaterials synthesized in this paper can be used as MRI/fluorescence dual-mode imaging contrast agents.

Calcifying Aponeurotic Fibroma: A Multimodal Imaging Description of an Unusual Case Involving Soft Tissues Adjacent to the Clavicle

Calcifying aponeurotic fibromas (CAFs) are rare benign tumors that typically develop in the soft tissue of the extremities. We report a case of 64-year-old woman with a CAF in the soft tissue surrounding her left clavicle. A plain radiograph showed an asymmetrical increase in opacity of the left internal clavicular region. Computed tomography and magnetic resonance imaging confirmed the presence of a heterogeneous lesion of the periclavicular soft tissue, with peripheral calcifications, and remodeling of the adjacent clavicular bone. Following ultrasound-guided biopsy and surgical resection of the mass, the final histological diagnosis was made. To the best of our knowledge, this is the first case of a CAF described in the soft tissue adjacent to the clavicle. It is essential to use all the diagnostic methods available (X-ray, ultrasound, CT, MRI, and percutaneous biopsy) to obtain the final diagnosis of this rare disease.

A Case of Large Calcifying Fibroma of Tendo-achilles Managed by En-block Resection and Tendon Reconstruction

Calcifying aponeurotic fibroma is a rare benign fibrous tumor with typical radiological and histopathological features seen in young children and adolescents. It commonly involves the extremities and is characterized by a very high chance of local recurrence. A complete excision of the tumor is considered to be the treatment of choice. We report a case of the tumor involving the substance of achilles tendon and extending up till its insertion in the calcaneum. To the best of our knowledge, this is the largest reported case of calcifying fibroma, with the tumor measuring 10 cm in its largest diameter. The tumor was excised in toto followed by reconstruction of the tendon defect with V-Y plasty of the native tendon and supplemented with semitendinosus and gracilis graft. There was no evidence of recurrence during the follow up period of 1 year.

Imaging of Pediatric Soft Tissue Tumors and Tumor-like Conditions

Lumps and bumps are frequently seen in children, and the vast majority are a result of trauma, infection, or inflammation. True soft tissue neoplastic lesions are rare; however, their wide and complex classifications make these lesions challenging to manage. Imaging features are usually nonspecific, and a reasonable list of differential diagnoses can be generated following consideration of the clinical presentation, age, and anatomical location of the lesion. In this article, we offer a practical approach to diagnosing such lesions by discussing the most common three benign and malignant lesions in different anatomical regions stratified by age with emphasis on certain features that might aid in the diagnosis such as depth, multiplicity, calcification, or other specific imaging feature.