Management of a Rare Digital Dermocutaneous Fibroma of the Flexor Tendon Sheath

We present the case of a 19-year-old gentleman with a rare digital dermocutaneous fibroma of the tendon sheath (FTS). The dermocutaneous and flexor sheath involvement of this mass presented unique challenges to wide excision and definitive soft tissue defect coverage. Fibroma of the tendon sheath is a benign lesion with a recurrence rate of up to 24%, giving it an aggressive profile. Previous reports of digital FTS are limited to subcutaneous involvement managed with simple excision and closure. To date, this is the first report of the successful treatment of a digital dermocutaneous FTS with wide excision and staged full-thickness skin grafting.