Hallux Mystery: A Rare Case of Fibro-Osseous Pseudotumor.
- 1Department of Orthopedic Surgery, Broomfield Hospital, Mid and South Essex Trust, Broomfield, United Kingdom.
Abstract
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. 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. 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.
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BibTeX
@article{buddhdev2026hallux,
title = {{Hallux Mystery: A Rare Case of Fibro-Osseous Pseudotumor.}},
author = {Pranai Buddhdev and Shraddha Gosatkar and Mohammad Ahmed},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8392},
url = {https://europepmc.org/article/MED/42997057},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Hallux Mystery: A Rare Case of Fibro-Osseous Pseudotumor.
AU - Pranai Buddhdev
AU - Shraddha Gosatkar
AU - Mohammad Ahmed
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8392
UR - https://europepmc.org/article/MED/42997057
AB - 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. 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. 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.
SN - 2250-0685
SN - 2321-3817
ER -