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 x-ray suggestive of a particular fibroma depends on the type of the fibroma. Findings on CT scan of ossifying fibroma include a well-circumscribed lesion, intracortical osteolysis with a characteristic sclerotic band, and moderate cortical expansion. Findings on CT scan of non- ossifying fibroma include sharply demarcated, asymmetrical, cortically based lucencies with a thin sclerotic rim. Findings on CT scan of chondromyxoid fibroma include a mild cortical expansion and characteristic lack of mineralization within chondromyxoid fibroma. Findings on CT scan of cemento-ossifying fibroma include a well circumscribed masses which expand the underlying bone.

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.

Chondromyxoid Fibroma

• On computed tomography (CT), mild cortical expansion may be observed, and the lesions have a density greater than fluid throughout.
• CT scans also exhibit characteristic lack of mineralization within chondromyxoid fibromas.

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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