Fibroma CT

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

Overview

CT scan may be helpful in the diagnosis of fibroma. Findings on CT scan suggestive of fibroma include diffuse, slightly hypoattenuating masses with poor, very slow contrast enhancement.

CT Findings

Ossifying Fibroma

Findings on CT scan of ossifying fibroma includes the following:

• Seen as a well-circumscribed lesion
• Demonstrates evidence of intracortical osteolysis with a characteristic sclerotic band (osteoblastic rimming)
• Moderate cortical expansion

Non-ossifying Fibroma

• Non-ossifying fibromas are typically sharply demarcated, asymmetrical, cortically based lucencies with a thin sclerotic rim.
• They often appear multiloculated.
• They are located in the metaphysis, adjacent to the physis. However, as the patient ages, they seem to migrate away from the growth plate.
• They have no associated periosteal reaction, cortical breach or associated soft tissue mass.

Ovarian Fibromas

• Fibromas usually manifest as diffuse, slightly hypoattenuating masses with poor, very slow contrast enhancement. Calcification and bilaterality are both uncommon.

Pleural Fibromas

• Tends to have soft tissue attenuation on unenhanced scans and show relatively homogenous intense background enhancement on contrast enhanced scans.
• Non-enhancing areas may be present corresponding to necrosis, myxoid degeneration, or haemorrhage within the tumour. A pedicular attachment may also be seen.

Cardiac Fibromas

• At CT, cardiac fibromas are homogeneous soft-tissue masses that are usually sharply marginated, but also can be infiltrative. Dystrophic calcification is common.

Key CT Findings in Fibroma

• Fibromas usually manifest as diffuse, slightly hypoattenuating masses with poor, very slow contrast enhancement. Calcification and bilaterality are both uncommon.

Chondromyxoid Fibroma

• On computed tomography (CT), mild cortical expansion may be observed, and the lesions have a density greater than fluid throughout.

Cemento-ossifying Fibroma

• Cemento-ossifying fibromas are usually well circumscribed masses which expand the underlying bone.
• They are usually small, but can become large. This is particularly the case when they arise from the maxilla or paranasal sinuses because there is more room to expand.
• They are initially lucent on x-ray with soft tissue attenuation on CT. As they mature, they gradually develop increasing amounts of calcification/ossification as they mature. *They usually expand the bone without cortical breach.
• Following administration of contrast, the soft tissue component usually enhances on CT.

Uterine Fibroma

• On CT scans, fibromas are usually of soft tissue density but may exhibit coarse peripheral or central calcification.
• They may distort the usually smooth uterine contour
• Enhancement pattern is variable

References

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