Hallux Mystery: A Rare Case of Fibro-Osseous Pseudotumor
Year: 2026
Type: article
Abstract: Introduction: Fibro-osseous pseudotumor of the digit (FOPD) is a rare benign growth characterised by fibroblastic proliferation and osteoid formation in subcutaneous tissue. This case report describes an uncommon presentation of a large FOPD lesion in the hallux, notably without nail bed involvement. Case Report: A 15-year-old male presented with a firm, growing lesion over the proximal phalanx of his right big toe, causing irritation donning shoe wear and limited joint movement. There was no involvement of the nailbed. Imaging suggested a lesion consisted with an Extensor Hallucis Longus tendon sheath tumor (giant cell tumor). Surgical excision produced a 4.5g, 28 × 22 × 15mm circumscribed mass with noted scalloping of the dorsal bone. Histological analysis demonstrated bony trabeculae, osteoclasts, osteoblasts, and a cartilaginous cap. This was consistent with a FOPD. This lesion is deemed benign and carries a favorable prognosis after complete removal, with local recurrence being uncommon. Conclusion: This unusual case highlights the importance of considering FOPD in the differential diagnosis for digital masses, including those in the foot. Complete surgical excision with clear margins is the treatment of choice, avoiding unnecessary morbidity. Early recognition through multidisciplinary evaluation involving clinical, radiologic, and histopathologic assessment is crucial for accurate diagnosis and optimal management of FOPD. Maintaining a high index of suspicion for this benign entity can prevent misdiagnosis and inappropriate treatment.
Institution: Broomfield Hospital
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225564534