PMC3909846_01
Calcifying aponeurotic fibroma of dorsal wrist in 67-year-old man.. AP (A), oblique (B) and lateral (C) radiographs of wrist demonstrate relatively ill-defined heterogeneously calcified soft tissue mass with extrinsic erosions (arrowheads in B) of adjacent carpal bones on dorsal ulnar aspect of wrist. Axial MR images (D-F) demonstrate ill-defined subcutaneous soft tissue mass, showing low to intermediate signal intensity on T1WI (D), heterogeneous mixture of low and high signal intensity on T2WI (E) and heterogeneously intense contrast enhancements on fat suppressed T1WI after intravenous gadolinium administration (F). Note that mass abuts tendons of extensor carpi ulnaris (short arrows in D-F) and extensor digiti minimi (arrows in D-F), erodes underlying carpal bones (arrowheads in D), and is associated with diffuse edema like signal changes in adjacent soft tissues of wrist. Photomicrograph (G) reveals scattered foci of calcification (white stars) and chondroid differentiation (asterisks) surrounded by peripheral less cellular, spindled fibroblastic component (arrows) between coalescent calcified and chondroid nodules (H&E stain, x 200). T1WI = T1-weighted image, T2WI = T2-weighted image
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F1
Cortical scalloping of the underlying carpal bones was demonstrated (Fig. 1A-C). T2-weighted image (T2WI). The mass showed heterogeneous intense contrast enhancement after intravenous gadolinium administration. The lesion had a poorly demarcated margin and was associated with edema like signal changes in the adjacent soft tissues on MR images (Fig. 1D-F). There were neither cellular atypism nor mitosis in the fibroblasts (Fig. 1G).