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Presented by Edward McCarthy, M.D. and prepared by Maryam Farinola M.D.
Case 6: A 30-year-old man had pain in his heel for six months.
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Question 1 of 1
1. Question
Week 184: Case 6
A 30-year-old man had pain in his heel for six months. A radiograph demonstrated a bubbly lytic lesion occupying most of his calcaneus./images/Desmoplastic fibroma 1.jpg
/images/Desmoplastic fibroma 2.jpg
/images/Desmoplastic fibroma 3.jpgCorrect
Answer: Desmoplastic fibroma
Histology: Desmoplastic fibroma is the intraosseous conterpart of fibromatosis. This is a non-metastasizing, but locally aggressive lesion consisting of brown spindle cells in a heavily collagenized matrix.
Discussion: The lesion is not a fibrosarcoma because there is no “herringbone” patten of cellular spindle cells. In addition, this lesion lacks nuclei atypia which is present in fibrosarcoma.
The lesion is not fibrous dysplasia. There is no woven bone present in this lesion typical of the fibroosseous nature of the fibrous dysplasia.
The lesion is not a malignant fibrous histiocytoma. Malignant fibrous histiocytoma is a high-grade sarcoma with significant nuclei atypia and cellular pleomorphism. The spindle cells of a malignant fibrous histiocytoma are commonly arranged in a storiform pattern, a patten which is lacking in this lesion.
Incorrect
Answer: Desmoplastic fibroma
Histology: Desmoplastic fibroma is the intraosseous conterpart of fibromatosis. This is a non-metastasizing, but locally aggressive lesion consisting of brown spindle cells in a heavily collagenized matrix.
Discussion: The lesion is not a fibrosarcoma because there is no “herringbone” patten of cellular spindle cells. In addition, this lesion lacks nuclei atypia which is present in fibrosarcoma.
The lesion is not fibrous dysplasia. There is no woven bone present in this lesion typical of the fibroosseous nature of the fibrous dysplasia.
The lesion is not a malignant fibrous histiocytoma. Malignant fibrous histiocytoma is a high-grade sarcoma with significant nuclei atypia and cellular pleomorphism. The spindle cells of a malignant fibrous histiocytoma are commonly arranged in a storiform pattern, a patten which is lacking in this lesion.
