Surgical Pathology Criteria

Palmar Fibromatosis

Differential Diagnosis

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

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