Fibroma overview
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Fibroma overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Fibromas (or fibroid tumors or fibroids) are benign tumors that are composed of fibrous or connective tissue. They can grow in all organs, arising from mesenchyme tissue.
The term "fibroblastic" or "fibromatous" is used to describe tumors of the fibrous connective tissue. When the term fibroma is used without modifier, it is usually considered benign, with the term fibrosarcoma reserved for malignant tumors.
The term fibroid can also refer to tumors of smooth muscle, as in uterine fibroids.
Historical Perspective
Ossifying fibroma was first described in 1872 by Menzel. In the year 1927 Montgomery coined the term “ossifying fibroma”. Chondromyxoid fibroma was first described in year 1948 by H L Jaffe and L Lichtenstein. The non-ossifying fibroma (NOF) was first recognized in 1941 by Sontag and Pyle. Desmoplastic fibroma was first described in year 1958 by H L Jaffe.[1][2][3]
Classification
There is no classification system established for fibroma. Based on the pathophysiology and location of the tumor, fibroma may be classified into hard fibroma, soft fibroma, angiofibroma, cystic fibroma, chondromyxoid fibroma, desmoplastic fibroma, nonossifying fibroma, ossifying fibroma, nuchal fibroma, collagenous fibroma, fibroma of tendon sheath, perifollicular fibroma, pleomorphic fibroma, uterine fibroma, neurofibroma, and ovarian fibroma.[4]
Pathophysiology
On gross pathology, polypoid lesion which is usually small, is characteristic findings of oral fibroma. On microscopic histopathological analysis, fibrous stroma, collagen bundles, prominent vessels, and overlying squamous mucosa with hyperkeratosis and focal ulceration are characteristic findings of oral fibroma. On gross pathology, well circumscribed, metaphyseal lesion, and fragments of white-grey rubbery tissue are characteristic findings of chondromyxoid fibroma. On microscopic histopathological analysis, spindle cells or stellate cells in a myxoid or chondroid stroma, lobules with hypocellular centers and hypercellular peripheries, giant cells in a hypercellular periphery, and scattered calcifications are characteristic findings of chondromyxoid fibroma. On gross pathology, fleshy, fibrous, yellow or tan-brown lesion with variable areas of haemorrhage are characteristic findings of non-ossifying fibroma. On microscopic histopathological analysis, spindle cells without cytologic atypia are arranged in a storiform pattern, scattered chronic inflammatory cells and benign giant cells, foam cells and hemosiderin deposition, and mitoses are characteristic findings of non-ossifying fibroma. On gross pathology, discrete mass that is well delineated from surrounding bone, tan-white, rubbery cut surface, firm to gritty and no encapsulation are characteristic findings of ossifying fibroma. On microscopic histopathological analysis, haphazardly distributed lamellated bony spicules on a background of fibrous stroma, a zonal architecture with a center of immature bone surrounded by more mature lamellar bone, and central spicules of woven bony trabeculae are lined by a layer of osteoblasts are characteristic findings of ossifying fibroma.[5][3]
Causes
Common causes of oral fibroma include trauma or chronic irritation. There are no established causes for chondromyxoid fibroma, non-ossifying fibroma, cemento-ossifying fibroma, and ossifying fibroma.[6][7][8][1]
Epidemiology and Demographics
Patients of all age groups may develop fibromas. However, the majority of fibromas are observed in adults. Fibromas usually affects men and women equally, however certain fibromas may show gender predilection. Fibromas are most often observed in adults, but they may occur in individuals of any age and either sex.[3]
Risk Factors
There are no established risk factors for fibroma.
Screening
Differentiating Fibroma from other Diseases
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI=
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Primary Prevention
Secondary Prevention
References
- ↑ 1.0 1.1 Bowers LM, Cohen DM, Bhattacharyya I, Pettigrew JC, Stavropoulos MF (2013). "The non-ossifying fibroma: a case report and review of the literature". Head Neck Pathol. 7 (2): 203–10. doi:10.1007/s12105-012-0399-7. PMC 3642261. PMID 23008139.
- ↑ Nedopil A, Raab P, Rudert M (2013). "Desmoplastic fibroma: a case report with three years of clinical and radiographic observation and review of the literature". Open Orthop J. 8: 40–6. doi:10.2174/1874325001307010040. PMC 3583030. PMID 23459513.
- ↑ 3.0 3.1 3.2 Fibroma. Radiopedia(2015) http://radiopaedia.org/articles/elastofibroma-dorsi Accessed on March 12, 2016
- ↑ fibroma. Wikipedia(2015) https://en.wikipedia.org/wiki/Fibroma Accessed on February 25, 2016
- ↑ Fibroma. Libre pathology(2015) http://librepathology.org/wiki/Fibroma Accessed on March 12, 2016
- ↑ Granter SR, Renshaw AA, Kozakewich HP, Fletcher JA (1998). "The pericentromeric inversion, inv (6)(p25q13), is a novel diagnostic marker in chondromyxoid fibroma". Mod Pathol. 11 (11): 1071–4. PMID 9831204.
- ↑ Yasuda T, Nishio J, Sumegi J, Kapels KM, Althof PA, Sawyer JR; et al. (2009). "Aberrations of 6q13 mapped to the COL12A1 locus in chondromyxoid fibroma". Mod Pathol. 22 (11): 1499–506. doi:10.1038/modpathol.2009.101. PMC 2784180. PMID 19648885.
- ↑ Nord KH, Lilljebjörn H, Vezzi F, Nilsson J, Magnusson L, Tayebwa J; et al. (2014). "GRM1 is upregulated through gene fusion and promoter swapping in chondromyxoid fibroma". Nat Genet. 46 (5): 474–7. doi:10.1038/ng.2927. PMID 24658000.