Achilles tendon nodule: inflammation, rupture, or tumor?

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Oncology
• Pathology

Background:

• Masses on the Achilles tendon require a broad differential diagnosis, including tumors, inflammation, and rupture.
• Fibroma of the tendon sheath can clinically resemble other common tendon sheath tumors, such as giant cell tumor of the tendon sheath.

Purpose of the Study:

• To highlight the importance of considering fibroma of the tendon sheath in the differential diagnosis of Achilles tendon masses.
• To emphasize the diagnostic methods and treatment for fibroma of the tendon sheath.

Main Methods:

• Review of a case report detailing the clinical presentation of fibroma of the tendon sheath.
• Discussion of diagnostic modalities including clinical examination, histologic examination, and plain film radiography.
• Outline of the standard surgical treatment approach.

Main Results:

• Clinical presentation of fibroma of the tendon sheath can be non-specific, mimicking other benign and malignant tendon sheath lesions.
• Histologic examination is the definitive method for differentiating fibroma from other tumors.
• Plain films may be useful to exclude bony involvement.

Conclusions:

• Fibroma of the tendon sheath is a differential diagnosis for Achilles tendon masses in active patients.
• Accurate diagnosis relies on histologic examination.
• Surgical excision is the recommended treatment, with a known recurrence rate of 25%.