Desmoplastic fibroma with malignant transformation

Intramedullary Fixation With a Short Nail in a Young Patient Presenting With a Pathological Proximal Femur Fracture

An 18-year-old man presented with a pathological fracture of the right proximal femur. Desmoplastic fibroma was diagnosed through histological studies. Surgical management involved extended intralesional curettage and fracture stabilization by open reduction with intramedullary nailing, using a short Gamma nail. At 42-month follow-up, the patient presented no limitations or recurrence. Internal fixation after prior intralesional curettage is a valid treatment strategy for pathological fractures in young patients. A short nail was chosen to prevent direct tumor cell seeding throughout the femur and future recurrence. Fracture consolidation was achieved because of the healing potential of a young patient.

Desmoplastic Fibroma of the Mandible in a Pediatric Patient: A Case Report of Resection and Reconstruction With A Six-Year Follow-Up

Desmoplastic fibroma (DF) of bone is considered a benign but locally aggressive tumor of fibroblastic origin. DF is rare, representing less than 1% of all bone tumors. Approximately 84% of patients are younger than 30 years. DF has a slow but aggressive growth potential and can recur locally when it has not been completely excised. Complete resection is the treatment of choice to decrease recurrence and morbidity. Mandibular reconstruction is mandatory in pediatric patients to ensure correct craniofacial development. The present report describes the case of a pediatric patient with mandibular DF in whom complete resection and immediate reconstruction with a fibula flap proved a satisfactory treatment option, with low morbidity and excellent esthetic and functional results at 6-year follow-up.

US and MRI appearance of a collagenous fibroma (desmoplastic fibroblastoma) of the shoulder

Collagenous fibroma (desmoplastic fibroblastoma) is a recently described rare benign tumor. Since this tumor was characterized by Evans in 1995, fewer than 100 cases have been reported in English literature with the largest series published by Miettinen and Fetsch. Preoperative radiological diagnosis is important to avoid over-treatment and unnecessary extensive procedures, but is difficult because diagnostic imaging findings for collagenous fibroma have not been established. Here we report the US and MRI appearance of a lesion localized deep under the deltoid muscle in a 34-year-old woman with a palpable painless mass. Histological findings were consistent with a collagenous fibroma. As far as we know, this is the first description of US appearance of a collagenous fibroma in English literature.

Desmoplastic fibroma arising in the distal phalanx of the great toe: a case report

Desmoplastic fibroma (DF) of the bone is a rare locally aggressive tumor usually occurring in adolescents and young adults. These tumors most commonly occur in the mandibles and metaphyses of long bones but are extremely rare in small bones, often resulting in diagnostic problems. The occurrence of these tumors in the foot is especially limited. We report the clinical, radiographic, and histologic features of DF arising in the distal phalanx of the great toe and a review of the published data.

Desmoplastic fibroma of the spine causing severe mediastinal compression and brachial plexus encasement: report of 2 cases

Desmoplastic fibroma (DF) is a rare bone tumor that accounts for about 0.1%-0.3% of all bone tumors. It is typically characterized as slow growing, but in rare cases it can proliferate extensively and exhibit locally aggressive characteristics. It is found most commonly in the appendicular skeleton and rarely in the axial skeleton. The authors present the cases of 2 women in their 20s with DF originating from the cervicothoracic spine. Both tumors intimately involved the brachial plexus and caused significant impingement of the mediastinum resulting in cardiopulmonary compromise. Both patients underwent hemiclamshell thoracotomies for tumor resection, and in both cases subtotal resection was performed given the encasement of the brachial plexus. Although DF is a benign process, it can be locally aggressive and proliferate at extensive rates. The authors describe these 2 cases, review the literature, and discuss management.

Desmoplastic fibroma: a case report with three years of clinical and radiographic observation and review of the literature

Background:

Desmoplastic fibroma (DF) is an extremely rare locally aggressive bone tumor with an incidence of 0.11% of all primary bone tumors. The typical clinical presentation is pain and swelling above the affected area. The most common sites of involvement are the mandible and the metaphysis of long bones. Histologically and biologically, desmoplastic fibroma mimics extra-abdominal desmoid tumor of soft tissue.

Case Presentation and Literature Review:

A case of a 27-year old man with DF in the ilium, including the clinical, radiological and histological findings over a 4-year period is presented here. CT scans performed in 3-year intervals prior to surgical intervention were compared with respect to tumor extension and cortical breakthrough. The patient was treated with curettage and grafting based on anatomical considerations. Follow-up CT scans over 18-months are also documented here. Additionally, a review and analysis of 271 cases including the presented case with particular emphasis on imaging patterns in MRI and CT as well as treatment modalities and outcomes are presented.

Conclusion:

In patients with desmoplastic fibroma, CT is the preferred imaging technique for both the diagnosis of intraosseus tumor extension and assessment of cortical involvement, whereas MRI is favored for the assessment of extraosseus tumor growth and preoperative planning. While tumor resection remains the preferred treatment for DF, curettage and grafting prove to be an acceptable alternative treatment modality with close follow-up when resection is not possible. Curettage and grafting have been shown to provide good clinical results and are associated with long recurrence free intervals.

Nonossifying Fibroma in the Mandible of a Goat

An 8-year-old male Nubian goat was presented with a peracute history of straining to urinate and unilateral mandibular swelling. At necropsy, the rostral half body of the left mandible was distorted by fusiform swelling that, on sagittal section, had marked medullary bone loss and replacement with a well-demarcated fibrous mass. Histologically, the mass comprised streaming spindloid cells with whorls and storiform patterns, interspersed with numerous multinucleated giant cells. Bone formation was not present in the neoplasm. The mandibular mass was diagnosed as nonossifying fibroma, a relatively common tumor in children but seldom reported in domestic animals.