Armenian cucumber
A rare benign soft tissue tumor
Aponeurotic fibroma, also known as calcifying aponeurotic fibroma, is a rare benign soft tissue tumor that typically occurs in the hands and feet of children and young adults. It is characterized by its slow-growing nature and potential for local recurrence after surgical excision.
Presentation
Aponeurotic fibroma usually presents as a firm, painless mass in the subcutaneous tissue or deep fascia. It is most commonly found in the palmar or plantar regions, but can also occur in other areas of the body. The tumor is often discovered incidentally or when it causes discomfort due to its location.
Pathology
The histological appearance of aponeurotic fibroma is distinctive. It is composed of fibroblastic and myofibroblastic cells arranged in a nodular pattern. The tumor often shows areas of calcification, which can be detected on imaging studies. The calcifications are typically small and scattered throughout the lesion.
Diagnosis
Diagnosis of aponeurotic fibroma is primarily based on histopathological examination. A biopsy of the lesion is performed to confirm the diagnosis and to differentiate it from other soft tissue tumors. Imaging studies such as X-ray or MRI may be used to assess the extent of the lesion and to identify calcifications.
Treatment
The primary treatment for aponeurotic fibroma is surgical excision. Complete removal of the tumor is necessary to minimize the risk of recurrence. However, due to the infiltrative nature of the tumor, achieving clear margins can be challenging. Recurrence is not uncommon, and repeated surgeries may be required.
Prognosis
The prognosis for individuals with aponeurotic fibroma is generally good, as it is a benign tumor with no potential for metastasis. However, the risk of local recurrence necessitates careful follow-up after surgical treatment.
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Contributors: Prab R. Tumpati, MD