Desmoplastic fibroma of Bone

Abstract

Desmoplastic fibroma of bone is a rare locally aggressive benign bone tumor. We describe the case of a 38-year-old female patient who presented with gradually progressive swelling of the right proximal arm for 3 years. The radiograph and computed tomogram revealed multiple thin linear and curvilinear radiopacities extending from the cortical surface of the proximal humerus, geographic bone destruction, and cortical disruption. On magnetic resonance imaging, the lesion was replacing the proximal medullary cavity with an associated large extraosseous soft tissue component demonstrating heterogeneous iso to hypointense signal on T2 weighted images. The biopsy revealed haphazardly arranged spindle cells in the background of dense collagenous stroma suggestive of desmoplastic fibroma. The patient underwent wide resection followed by reconstruction with mega prosthesis. The spectrum of imaging characteristics on radiograph, computed tomography, and magnetic resonance imaging along with the management are discussed in detail. Radiologists need to identify typical imaging characteristics of desmoplastic fibroma, which can mimic aggressive malignant bone tumors radiologically. Its locally aggressive behavior and high recurrence rate compared to other benign lesions necessitates a wide excision.