Korean J Radiol.  2013 Oct;14(5):818-822. 10.3348/kjr.2013.14.5.818.

Desmoid Type Fibromatosis in the Facet Joint of Lumbar Spine: Case Report and Review of Literature

• Kim SJ
• Ha DH
• Lee SM
• Kang H

• KMID: 1711440
• DOI: http://doi.org/10.3348/kjr.2013.14.5.818

Abstract

Desmoid type fibromatosis is a benign fibroblastic tumor arising from the fascia or musculoaponeurosis. It may occur in various locations, but most commonly in the shoulder girdle and neck; to our knowledge, there has been no reported case originating from a facet joint of the spine. We report CT and MR imaging findings of a desmoid type fibromatosis, involving the facet joint of the L3-4 spine with bone involvement.

Keyword

Desmoid type fibromatosis; Soft tissue tumor; Facet joint, spine; Spine, CT; Spine, MR

MeSH Terms

Adult
Biopsy
Fibromatosis, Aggressive/*diagnosis
Humans
*Lumbar Vertebrae
Magnetic Resonance Imaging
Male
Spinal Neoplasms/*diagnosis
*Zygapophyseal Joint

Figure

• 

  Fig. 1 Desmoid type fibromatosis of lumbar facet joint in 31-year-old man. A. Oblique conventional radiograph shows bony erosive lesion with sclerotic rim (arrow) on left L3-4 facet joint. B, C. Axial CT images with soft tissue setting (B) and bone setting (C) show isodense soft tissue mass (arrows) to muscle on posterior portion of left L3-4 facet joint. Lesion reveals bony erosion on both L3 inferior and L4 superior articular processes with mild sclerosis. D. T1-weighted axial MR image shows isosignal soft tissue mass (arrows) to that of muscle on left L3-4 facet joint. E. T2-weighted axial MR image reveals intermediate signal mass (arrows) between those of muscle and cerebrospinal fluid. F. Gadolinium-enhanced fat-suppressed T1-weighted axial MR images reveal well contrast enhancing lesion with extracapsular soft tissue infiltration (arrow). G. Photomicroscopy of tumor shows proliferation of spindle-shaped cells of fibroblasts with collagenous stroma without nuclear atypia or mitosis (Hematoxylin and Eosin stain, × 200). H. Immunostain for smooth muscle actin shows positive reaction (× 200).

Reference

1. Weiss SW, Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. 4th ed. St. Louis, USA: Mosby, Inc.;2001. p. 320–329.

2. Shields CJ, Winter DC, Kirwan WO, Redmond HP. Desmoid tumours. Eur J Surg Oncol. 2001; 27:701–706.

3. McDougall A, McGarrity G. Extra-abdominal desmoid tumours. J Bone Joint Surg Br. 1979; 61-B:373–377.

4. Abramowitz D, Zornoza J, Ayala AG, Romsdahl MM. Soft-tissue desmoid tumors: radiographic bone changes. Radiology. 1983; 146:11–13.

5. Griffiths HJ, Robinson K, Bonfiglio TA. Aggressive fibromatosis. Skeletal Radiol. 1983; 9:179–184.

6. Taylor LJ. Musculoaponeurotic fibromatosis. A report of 28 cases and review of the literature. Clin Orthop Relat Res. 1987; 294–302.

7. Hartman TE, Berquist TH, Fetsch JF. MR imaging of extraabdominal desmoids: differentiation from other neoplasms. AJR Am J Roentgenol. 1992; 158:581–585.

8. Shindle MK, Khanna AJ, McCarthy EF, O'Neill PJ, Sponseller PD. Desmoid tumor of the spinal canal causing scoliosis and paralysis. Spine (Phila Pa 1976). 2002; 27:E304–E307.

9. Kawashima A, Fishman EK, Hruban RH, Kuhlman JE. Intrathoracic paraspinal desmoid with intracanalicular extension: computed tomography and magnetic resonance imaging findings. Orthopedics. 2000; 23:381–382.

10. Murphey MD, Ruble CM, Tyszko SM, Zbojniewicz AM, Potter BK, Miettinen M. From the archives of the AFIP: musculoskeletal fibromatoses: radiologic-pathologic correlation. Radiographics. 2009; 29:2143–2173.

11. Yao L, Toranji S, Doberneck SA, Eckardt JJ. Case report 818: Pericapsular desmoid tumor of the knee. Skeletal Radiol. 1994; 23:217–219.

12. Francis IR, Dorovini-Zis K, Glazer GM, Lloyd RV, Amendola MA, Martel W. The fibromatoses: CT-pathologic correlation. AJR Am J Roentgenol. 1986; 147:1063–1066.

13. Lee JC, Thomas JM, Phillips S, Fisher C, Moskovic E. Aggressive fibromatosis: MRI features with pathologic correlation. AJR Am J Roentgenol. 2006; 186:247–254.

14. Hawnaur JM, Jenkins JP, Isherwood I. Magnetic resonance imaging of musculoaponeurotic fibromatosis. Skeletal Radiol. 1990; 19:509–514.

15. Sundaram M, McGuire MH, Schajowicz F. Soft-tissue masses: histologic basis for decreased signal (short T2) on T2-weighted MR images. AJR Am J Roentgenol. 1987; 148:1247–1250.

16. Vandevenne JE, De Schepper AM, De Beuckeleer L, Van Marck E, Aparisi F, Bloem JL, et al. New concepts in understanding evolution of desmoid tumors: MR imaging of 30 lesions. Eur Radiol. 1997; 7:1013–1019.

17. Osipov V, Carrera GF. Collagenous fibroma (desmoplastic fibroblastoma) with vertebral body erosion. Sarcoma. 2009; 2009:682687.

18. Beggs I, Salter DS, Dorfman HD. Synovial desmoplastic fibroblastoma of hip joint with bone erosion. Skeletal Radiol. 1999; 28:402–406.

19. Harish S, Kuruvilla M, Alowami S, DeNardi F, Ghert M. Intraarticular nodular fasciitis of the shoulder: a case report and review of the literature. Skeletal Radiol. 2011; 40:1383–1386.

20. Hornick JL, Fletcher CD. Intraarticular nodular fasciitis--a rare lesion: clinicopathologic analysis of a series. Am J Surg Pathol. 2006; 30:237–241.

21. Oe K, Sasai K, Yoshida Y, Ohnari H, Iida H, Sakaida N, et al. Pigmented villonodular synovitis originating from the lumbar facet joint: a case report. Eur Spine J. 2007; 16 Suppl 3:301–305.

22. Rovner J, Yaghoobian A, Gott M, Tindel N. Pigmented villonodular synovitis of the zygoapophyseal joint: a case report. Spine (Phila Pa 1976). 2008; 33:E656–E658.