Fibroma of tendon sheath is a circumscribed, often multinodular, tumor that occurs in the extremities and most often affects the hands, fingers and wrists. It affects all ages of patients but is most commonly reported in adults. It grows very slowly and may be present for months or even years; it is rarely painful. This tumor is usually less than 2 centimeters in diameter. Many fibromas of tendon sheaths are attached to a tendon sheath, but not all arise from this location. They may be present in the superficial soft tissues outside of the tendon sheath. These are well-circumscribed tumorsâ€”that is, they have a substantial capsule surrounding them. Most are multinodular. Treatment consists of excision. Approximately 25% of these lesions have been reported to recur following surgical excision, presumably due to failure of removal of all lobules at the initial surgery. These tumors, however, do not recur aggressively, do not metastasize, and typically do not interfere with the patient's function.