Palmar Fibromatosis
Differential Diagnosis
- Calcifying aponeurotic fibroma
- Extra-abdominal desmoid fibromatosis
- Fibrosarcoma
- Synovial sarcoma
- Epithelioid sarcoma
- Inclusion body fibromatosis
| Palmar or Plantar Fibromatosis | Calcifying Aponeurotic Fibroma |
|---|---|
| Rare under 20 | Predominantly <20 |
| Not calcified | Calcified |
| Rarely chondroid | Chondroid |
| No muscle or nerve infiltration | May infiltrate muscle and nerve |
| Extra-abdominal Desmoid Fibromatosis | Palmar and Plantar Fibromatosis |
|---|---|
| Rare on hands and feet | Occurs on hands and feet |
| Primarily one large mass | Multiple small nodules |
| Infiltrates muscle | No muscle infiltration |
| Palmar or Plantar Fibromatosis | Adult Fibrosarcoma |
|---|---|
| Occurs in hands | Rare in hands |
| Multiple small nodules | Single large mass |
| Involves fascia | Deep to fascia |
| Haphazard pattern | Herringbone pattern |
| Cytologically bland | Cytologically atypical |
| No atypical mitotic figures | Atypical mitotic figures may be seen |
| Rarely necrotic | Frequent necrosis |
| Palmar or Plantar Fibromatosis | Synovial Sarcoma |
|---|---|
| Rare under age 20 | Frequently under age 20 |
| Multiple small nodules | Single large mass |
| Not biphasic | May be biphasic |
| Variable cellularity | Uniformly hypercellular |
| Lacks ropy collagen, calcification and stag horn vessels | May have ropy collagen, calcification and stag horn vessels |
| No SYT-SSX fusion | SYT-SSX fusion present |
| Palmar or Plantar Fibromatosis | Epithelioid Sarcoma |
|---|---|
| Necrosis absent | Necrosis common |
| No epithelioid cells | Epithelioid cells present |
| Cytologicially bland | Cytologically atypical |
| Keratin negative | Keratin positive |
| CD34 negative | CD34 50% positive |
| Palmar or Plantar Fibromatosis | Inclusion Body Fibromatosis |
|---|---|
| Usually in palm or sole | Usually on digits |
| Uncommon in children | Vast majority very young |
| No inclusions | Inclusions |
