Tendon sheath fibromas is a rare proliferative mass, with common imaging features of tenosynovial giant cell tumors.
There is a 3:1 male predominance and arise between the 2nd to 5th decades 2.
Tendon sheath fibromas are lobulated, round-to-oval, encapsulated masses consisting of spindle cells and collagen fibers that arise from the synovium of a tendon sheath 1,2.
Tendon sheath fibromas can arise around 2,3:
- small joints
- finger (~50%)
- hand (~25%): most commonly the flexor surface
- wrist (~10%)
- large joints (~5%): knee, shoulder, elbow and ankle
They can be intra-articular or extra-articular 2.
- T1: low-to-iso signal
- T2: heterogeneous
- GRE: absent susceptibility artifact
- T1C+: no or variable contrast enhancement
Treatment and prognosis
Treatment is usually surgical excision. There is a very low recurrence rate, and these tumors are not reported to have undergone malignant transformation 3.
- 1. Benjamin Plotkin, Srihari C. Sampath, Srinath C. Sampath, Kambiz Motamedi. MR Imaging and US of the Wrist Tendons. (2016) RadioGraphics. 36 (6): 1688-1700. doi:10.1148/rg.2016160014 - Pubmed
- 2. Suzuki K, Yasuda T, Suzawa S, Watanabe K, Kanamori M, Kimura T. Fibroma of tendon sheath around large joints: clinical characteristics and literature review. (2017) BMC musculoskeletal disorders. 18 (1): 376. doi:10.1186/s12891-017-1736-5 - Pubmed
- 3. Heckert R, Bear J, Summers T, Frew M, Gwinn D, McKay P. Fibroma of the tendon sheath - a rare hand tumor. (2012) Polski przeglad chirurgiczny. 84 (12): 651-6. doi:10.2478/v10035-012-0107-z - Pubmed