Age / Sex : 45 / M

Chief complaint : Bilateral palpable mass

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).


Courtesy : 박은혜 Eun Hae Park, 전북대학교병원 Chonbuk National University Hospital

Plantar fibromatosis (Ledderhose disease)

Discussion

Findings:

• Infiltrative, fibroblastic lesions most commonly found arising from palmar or plantar fascia or aponeuroses


• Plantar location: non-weight bearing plantar aponeurosis

Usually medial (20-50% bilateral), 2-3 cm

• Age : occurs b/w ages of 30~50


• well- or ill-defined superficial soft-tissue mass occurring along the deep plantar


• aponeurosis


• Nodular lesion that blends with plantar aponeurosis at proximal and distal ends


• Predominantly Iso to hypo-intense relative to skeletal muscle on T1WI and T2WI


• less frequently manifest high signal intensity on T2WI  


• Enhancement : Variable, heterogeneous enhancement 

Discussion:

•  When plantar fibromatosis manifest high signal intensity on T2WI (like in present case)

= high cellularity, less collagen, high recurrence rate

References:

 Musculoskeletal Fibromatoses:Radiologic-Pathologic Correlation. RadioGraphics 2009; 29:2143–2176