Superficial Fibromatosis: Understanding Your Pathology Report

Section Editor: Bibianna Purgina MD FRCPC
September 21, 2026

Superficial fibromatosis is a noncancerous growth made of fibrous tissue, the tough connective tissue that supports and holds the body together. It develops just under the skin, most often in the hand or the foot. It is one of the two main groups of fibromatosis, along with deep fibromatosis.

Superficial fibromatosis is not a cancer. It does not spread to other parts of the body or turn into cancer. It grows slowly and mainly causes problems by thickening and tightening the surrounding tissue, which can limit movement.

This article explains how superficial fibromatosis is diagnosed and what your pathology report findings mean.

What are the types of superficial fibromatosis?

Superficial fibromatosis is named for where it develops in the body. They look the same under the microscope:

Palmar fibromatosis. This type affects the palm and is also called Dupuytren contracture. It is the most common type, it becomes more common with age, and it often affects both hands. Our article on palmar fibromatosis describes it in detail.
Plantar fibromatosis. This type affects the sole, usually the arch, and is also called Ledderhose disease. Our article on plantar fibromatosis describes it in detail.
Penile fibromatosis. This type affects the penis and is also called Peyronie disease. It usually affects men over 40.

A person can develop more than one type. For example, some people with palmar fibromatosis also develop plantar or penile fibromatosis.

What causes superficial fibromatosis?

The exact cause of superficial fibromatosis is not known. The tumor develops when fibroblasts and myofibroblasts, the cells that build and repair connective tissue, multiply and produce extra collagen in one area.

Several factors are linked to a higher chance of developing palmar fibromatosis:

Family history and ancestry. The condition often runs in families and is most common in people of Northern European ancestry. In England and Denmark, studies estimate it affects about 3.5% to 11% of people.
Age and sex. It becomes more common with age and affects men more often than women.
Health conditions. Diabetes and epilepsy are both linked to a higher chance of developing it.
Smoking and alcohol. Heavy smoking and heavy alcohol use have both been linked to it.

An injury does not cause superficial fibromatosis, although some people notice it after one. It is not contagious, and it is not related to any cancer in the family.

What are the symptoms of superficial fibromatosis?

The symptoms of superficial fibromatosis depend on where it develops:

Palm. A firm lump in the palm, often near the base of the ring or little finger. Over time, a thickened cord may form and pull one or more fingers toward the palm so that they cannot be straightened.
Sole. One or more firm lumps in the arch. These may be painful when standing or walking, or when wearing certain shoes. Unlike the hand, the toes are usually not pulled out of position.
Penis. Firm areas that can cause curving during an erection, pain, or difficulty with intercourse.

The lumps are often painless at first. Many people notice the loss of movement before they notice the lump itself.

How is the diagnosis made?

A doctor often identifies superficial fibromatosis during a physical exam, without removing any tissue. A pathology report is produced when tissue is removed to relieve symptoms, usually in a procedure called an excision.

Under the microscope, superficial fibromatosis is made of long, thin spindle cells that look very similar to the cells in normal fibrous tissue. These cells are fibroblasts and myofibroblasts. Unlike normal fibrous tissue, they form small, rounded groups called nodules and are surrounded by dense pink collagen.

The number of cells changes as the condition ages. Early lesions contain many cells and are described as cellular. Older lesions contain fewer cells and more collagen, and are described as hypocellular. Both appearances are expected, and neither one means the condition is more or less serious.

In most cases, no additional tests are needed. The combination of location, microscopic appearance, and clinical history is enough to make the diagnosis.

Immunohistochemistry

Immunohistochemistry is a test that uses antibodies to show which proteins cells make. It is usually not needed for superficial fibromatosis. When it is performed, the cells are often positive for SMA, a protein found in myofibroblasts.

Your report may also mention beta-catenin. This protein can build up in the nucleus of the cells in superficial fibromatosis as well as in deep fibromatosis, so the stain does not separate the two. The location of the tumor and its size are what distinguish them.

Margins

A margin is the edge of tissue cut by the surgeon. For most tumors, a positive margin means tumor cells reach the cut edge, and some tissue may remain.

For superficial fibromatosis, surgery aims to restore movement rather than remove every cell. The surgeon removes the thickened cord or nodule that is causing symptoms, so the report often describes tissue extending to a margin. This finding is expected. It does not mean that something was missed, although it is one reason the condition can come back in the same area.

What is the prognosis?

Superficial fibromatosis is not life-threatening and does not spread. The main issue is that it can progress slowly over years and can come back after treatment.

Recurrence depends partly on which treatment was used. In a five-year comparison of treatments for palmar fibromatosis, recurrence was most common after a needle procedure. It was less common after an injection, and least common after surgical removal of the thickened tissue. Even after surgery, some people develop the condition again in the same hand or in the other hand.

Coming back after treatment does not mean the condition has become cancerous. It reflects the underlying tissue’s tendency to thicken again.

What happens after the diagnosis?

Treatment depends on how much the condition affects the use of your hand or foot. A person with a painless lump and normal movement often needs no treatment.

Observation. Many people are monitored, since the condition often progresses slowly or not at all.
Injections. A steroid injection may ease pain. For palmar fibromatosis, an injection of an enzyme called collagenase can break down the thickened cord and improve finger movement.
Needle procedures. A fine needle can divide the cord in the palm. Recovery is quick, but the condition comes back more often than after surgery.
Surgery. The thickened tissue is removed, which usually gives the most lasting improvement in hand movement. Recovery takes longer, and hand therapy is often part of the plan.
Foot and penile disease. Plantar fibromatosis is often managed with padding or custom shoe inserts before considering any procedure. A urologist manages penile fibromatosis, and options include injections and surgery.

A surgeon who specializes in the hand or foot usually provides treatment. Your team can explain which options apply to your situation and what recovery involves.

Questions to ask your doctor

Which type of superficial fibromatosis do I have?
Does the report say whether the tissue extended to a margin, and does that matter here?
Is my condition likely to get worse over time?
Do I need treatment now, or can this be watched?
Which treatment options are suitable for me?
How likely is it to come back after that treatment?
Will I need hand or foot therapy afterward?
Should my other hand or foot be checked?
Are any of my other health conditions making this worse?
Who should I see if the condition returns?