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Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

SCImago Journal Rank (SJR) 2014: 0.183
Source Normalized Impact per Paper (SNIP) 2014: 0.242
Impact per Publication (IPP) 2014: 0.339

Open Access


Fibroma of the Tendon Sheath – A Rare Hand Tumor

Reed Heckert1 / Jonathan Bear23 / Thomas Summers Jr4 / Michael Frew5 / David Gwinn1 / Patricia McKay2

1Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda

2Naval Medical Center San Diego, San Diego

3Uniformed Services University of the Health Sciences 4301 Jones Bridge Road, Bethesda, MD 20814, USA

4Department of Pathology and Laboratory Sciences, Walter Reed National Military Medical Center, Bethesda

5Department of Radiology, Walter Reed National Military Medical Center, Bethesda

This content is open access.

Citation Information: Polish Journal of Surgery. Volume 84, Issue 12, Pages 651–656, ISSN (Online) , ISSN (Print) 0032-373X, DOI: 10.2478/v10035-012-0107-z, February 2013

Publication History

Published Online:


Fibroma of the tendon sheath (FTS) is a rare, benign, soft tissue lesion. Clinically, FTS presents similarly to the more common giant cell tumor of the tendon sheath. It is distinguished histologically by the lack of giant cells, foamy histiocytes and synovial cells.

We presented a case of FTS involving the common tendon sheath surrounding the flexor tendons leading to the third metacarpal. A 63-year-old man presented with a 3-month history of a painless mass in his right palm that had recently tripled in size. Examination demonstrated a 5x4 cm firm, nodular, superficial mass that was adherent to the overlying skin. Radiographs of the hand revealed a soft tissue mass without bony abnormality. Ultrasound demonstrated a solid, heterogeneous and hypoechoic mass and computed tomography demonstrated that the mass centered predominantly at the mid and distal portions of the third metacarpal. The patient underwent excisional biopsy of the lesion and a palmar, longitudinal incision was made from the wrist to the third metacarpal. Submitted histologic sections revealed a well-circumscribed lesion closely resembling hyalinized collagen. Neither vascular proliferations, necrosis, nor mitoses were observed. Similarly, multinucleated giant cells, pigment-laden macrophages, and inflammatory cells were also not identified. A diagnosis of FTS was rendered. We provided an additional rare case to the literature of a FTS and highlight the need to consider this entity in the differential diagnosis for any soft tissue lesion in the hand. Three months post surgery the patient demonstrated full range of motion of the hand

Keywords : fibroma; tendon sheath; FTS; soft tissue tumor; hand lesion

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