By Murray F Brennan; Jonathan J Lewis; James M Woodruff
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Extra info for Diagnosis and Management: Soft Tissue Sarcoma
These benign lesions have a tendency to recur after simple excision. Plantar fibromatosis (Ledderhose’s disease) tends to occur in a somewhat younger age group, but may occur with greater frequency in patients with palmar fibromatosis. Penile fibromatosis (Peyronie’s disease), which causes pain and curvature of the penis on erection, is much less common. The fibrous mass in Peyronie’s disease primarily involves fascial structures, the corpus cavernosum, and, rarely, the corpus spongiosum. Peyronie’s disease is more common in men with palmar and plantar fibromatosis than in the general population.
These tumors grow slowly as circumscribed lobulated masses and are usually diagnosed when they are less than 5 cm in diameter. Because of their location, excision is often done with close margins. Local recurrence is seen in 10–20% of patients. A diffuse form of giant cell tumors occurs in and around joints, most commonly around the knee or ankle. In contrast to most giant cell tumors, this 44 Diagnosis and Management of Soft Tissue Sarcoma neoplasm grows in expansive sheets without a mature capsule.
Mesenchymal tissues other than fibroblasts are also involved. Gingival fibromatosis is often familial and appears when permanent teeth erupt. Other anomalies such as hypertrichosis and neurofibromatosis have been reported in association with gingival fibromatosis. Surgical excision with clean margins is the best assurance against recurrence. Aponeurotic fibromatosis is an uncommon tumor-like proliferation of fibroconnective tissue cells with foci of calcification and ossification and areas of cartilaginous differentiation.
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