Rare case report of a 14 year old female with a painful benign spindle cell neoplasm of fibroma within the tendon sheath of the hallux

Abstract

Our aim is to illustrate a rare case report of a painful benign spindle cell neoplasm of fibroma within the tendon sheath in the great toe of a 14 year old female that aggressively infiltrated the EHL tendon. Our patient reported one year after noticing the lesion on her foot after she was stepped on during physical education class and over the course of the year the mass continued to progress and expand making it painful and difficult to wear shoe gear. An MRI was completed which showed concern for a giant cell tumor, although surgical pathology determined it to be a benign spindle cell neoplasm of the tendon sheath. Of note, some pathologists believe that the precursor to said lesion is a giant cell tumor, which may be the reason the tumor aggressively infiltrated the long extensor tendon of the great toe. A staged procedure was carried out, first with complete surgical excision of the tumor followed by reconstruction of the tendon with a split peroneus longus autograft.