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Differential Diagnostic Considerations of Desmoid-type Fibromatosis

Goldstein, Jeffery A. MD, PhD; Cates, Justin M.M. MD, PhD

Advances In Anatomic Pathology: July 2015 - Volume 22 - Issue 4 - p 260–266
doi: 10.1097/PAP.0000000000000077
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Fibrous and myofibroblastic tumors of soft tissue often present the surgical pathologist with a difficult differential diagnosis because of the number of diagnostic possibilities and morphologic similarities among cytologically bland spindle-cell tumors. Prototypical in this regard is desmoid-type fibromatosis. In a review of 320 surgical specimens diagnosed as desmoid tumor, 94 (29%) were discovered to be misclassified as such. The most common lesions in this series were Gardner fibroma, scar tissue, superficial fibromatosis, nodular fasciitis, myofibroma, and collagenous fibroma. Four sarcomas were also misinterpreted as desmoid-type fibromatosis (3 low-grade fibromyxoid sarcomas and 1 unclassified spindle-cell sarcoma). We take this opportunity to compare and contrast desmoid tumor and several of the soft tissue tumors that should be considered in the differential diagnosis thereof.

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Department of Pathology, Vanderbilt University Medical Center, Nashville, TN

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website, www.anatomicpathology.com.

The authors have no funding or conflicts of interest to disclose.

Reprints: Justin M.M. Cates, MD, PhD, Department of Pathology, Vanderbilt University Medical Center, Medical Center North, CC-3322, 1161 21st Ave. South, Nashville, TN 37232 (e-mail: justin.m.cates@vanderbilt.edu).

All figures can be viewed online in color at http://www.anatomicpathology.com.

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