Fibroma differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2], Simrat Sarai, M.D. [3]

Overview

Oral fibroma must be differentiated from squamous papilloma, giant cell fibroma, neurofibroma, peripheral giant cell granuloma, mucocele, and benign and malignant salivary gland tumors. Non-ossifying fibroma must be differentiated from fibrous cortical defect, aneurysmal bone cyst, chondromyxoid fibroma, fibrous dysplasia, desmoplastic fibroma, giant cell tumor of bone, and spindle cell lesions of bone. Ossifying fibroma must be differentiated from ossifying fibroma, fibrous dysplasia, adamantinoma, and osteoid osteoma. Chondromyxoid fibroma must be differentiated from aneurysmal bone cyst (ABC), giant cell tumor of bone (GCT), non-ossifying fibroma, chondroblastoma, chondrosarcoma, and phosphaturic mesenchymal tumor. Desmoplastic fibroma must be differentiated from giant cell tumor of bone (GCT), non- ossifying fibroma (NOF), fibrous dysplasia, low grade fibrosarcoma, unicameral bone cyst, chondromyxoid fibroma, periosteal desmoids, eosinophilic granuloma, low-grade intraosseous osteosarcoma, adamantinoma, and distant metastasis.

Differential Diagnosis

Type of Fibroma	Differential Diagnosis
Ovarian fibroma	Large pedunculated subserosal uterine leiomyoma Thecoma Leiomyoma Fibrosarcoma Metastatic metaplastic carcinoma Endometriosis with extensive fibrosis.
Non-ossifying fibroma	Fibrous cortical defect Aneurysmal bone cyst Chondromyxoid fibroma Fibrous dysplasia Desmoplastic fibroma Giant cell tumor of bone Spindle cell lesions of bone
Ossifying Fibroma	Fibrous dysplasia Adamantinoma Osteoid osteoma
Chondromyxoid Fibroma	Aneurysmal bone cyst (ABC) Giant cell tumor of bone (GCT) Non ossifying fibroma Chondroblastoma Chondrosarcoma Phosphaturic mesenchymal tumor
Desmoplastic Fibroma	Giant cell tumor of bone (GCT) Non ossifying fibroma (NOF) Fibrous dysplasia Low grade fibrosarcoma Unicameral bone cyst Chondromyxoid fibroma Periosteal desmoids Eosinophilic granuloma Low-grade intraosseous osteosarcoma Adamantinoma Distant metastasis
Pleural Fibroma	Considerations for extremely well defined lesions include: Pleural lipoma Pleural fibrosarcoma Intercostal nerve neurilemoma (schwannoma) If not extremely well defined, broader considerations include: Organised inflammation Peripheral bronchogenic carcinoma Solitary pleural metastasis Also consider the differential for a single pleural mass which includes the following: Pleural tumors Solitary fibrous tumour of the pleura (pleural fibroma) Mesothelioma Localised mediastinal malignant mesothelioma Metastatic pleural disease, particularly from adenocarcinomas Pleural lymphoma Invasive thymoma Lipoma Pleural effusion Empyema Haemothorax Ewing sarcoma of chest wall, Askin tumor Intercostal nerve neurilemmoma Splenosis Tuberculosis
Renal Medullary Fibroma	Renal myxoma
Cemento-ossifying Fibroma	Fibrous dysplasia Ameloblastic fibro odontoma Odontoma Calcifying epithelial odontogenic tumour (Pindborg tumour) Odontogenic cyst Calcifying odontogenic cyst (Gorlin cyst) Osteochondroma Osteosarcoma Chondrosarcoma
Desmoplastic fibroblastoma (Collagenous fibroma)	Fibromatosis Elastofibroma Low-grade fibromyxoid sarcoma.
Ameloblastic Fibroma	Ameloblastoma
Giant cell fibroma	Squamous Papilloma Irritation fibroma Pyogenic granuloma Peripheral giant cell granuloma.
Oral Fibroma	Squamous Papilloma Giant cell fibroma Neurofibroma Peripheral giant cell granuloma Mucocele Benign and malignant salivary gland tumors
Uterine Fibroma	Uterine leiomyosarcoma Uterine smooth muscle tumors of uncertain malignant potential Uterine lipoleiomyoma Ovarian masses Focal myometrial contraction (Braxton Hicks contraction): especially if seen during pregnancy Focal adenomyosis
Peripheral odontogenic fibroma	Inflammatory gingival hyperplasia Peripheral cemento-ossifying fibroma Peripheral giant cell granuloma
Elastofibroma	Spindle cell lipoma Nuchal-type fibroma Fibromatosis colli