Imaging of musculoskeletal fibromatosis

The musculoskeletal fibromatoses comprise a wide range of lesions with a co mmon histopathologic appearance. They can be divided into two major groups: superficial and deep. The superficial fibromatoses are typically small, sl ow-growing lesions and include palmar fibromatosis., plantar fibromatosis, juvenile aponeurotic fibroma, and infantile digital fibroma. The deep fibro matoses are commonly large, may grow rapidly, and are more aggressive. They include infantile myofibromatosis, fibromatosis colli, extraabdominal desm oid tumor and aggressive, infantile fibromatosis. Radiographs typically rev eal a nonspecific soft-tissue mass, and calcification is common only in juv enile aponeurotic fibroma. Advanced imaging (ultrasonography, computed tomo graphy, and magnetic resonance [MR] imaging) demonstrates lesion extent. In volvement of adjacent structures is common, reflecting the infiltrative gro wth pattern often seen in these lesions. MR imaging may show characteristic features of prominent low to intermediate signal intensity and bands of lo w signal intensity representing highly collagenized tissue. However, fibrom atoses with less Collagen and more cellularity may have nonspecific high si gnal intensity on T2-weighted images. Local recurrence is frequent after su rgical resection due to the aggressive lesion growth. It is important for r adiologists to recognize the imaging characteristics of musculo skeletal fi bromatoses to help guide the often difficult and protracted therapy and man agement of these lesions.