Age / Sex : 27 / F

Chief complaint : Op. site swelling, pain ; Paraplegia d/t thoracic spinal cord injury.

S/P, corpectomy T5-6 & lat. interbody fusion & lat. screw fixation T4-7 (1year 8month ago, motorcycle TA)

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 : 차장규, Jang Gyu Cha, Soonchunhyang University Bucheon Hospital 순천향대학교 부천병원

Desmoid-type fibromatosis

Discussion

Findings

• T1 isointense T2 hyperintense enhancing mass in left paramedian area, T8-9-10 level.

• locally aggressive fibroblastic neoplasm with no potential for metastasis


• arise anywhere in the body


• rare, with an estimated annual incidence of 2–4 new cases per million people


• frequently affects individuals between the ages of 15 and 60 years, with a peak incidence in the third and fourth decades of life.


• The vast majority of DF occurs sporadically; however, it may also occur in association with the hereditary syndrome familial adenomatous polyposis (FAP)


• can be classified, in accordance with its location, as extra-abdominal, intra-abdominal, or abdominal wall.


• slow-growing painless or minimally painful soft-tissue masses

• Signal intensity of DF at MR imaging, in the various imaging sequences, is reflective of the proportion of collagen fibers, spindle cells, and extracellular matrix present.


• m/c MR imaging appearance : heterogeneous pattern, with signal iso- to hyperintense to skeletal muscle on T2WI, and isointense to muscle on T1WI.

• Role of Imaging in Management of Desmoid-type Fibromatosis: A Primer for Radiologists (RadioGraphics 2016; 36:767–782)