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.[1][1][1][1]
CT Findings
Ossifying Fibroma
Findings on CT scan of ossifying fibroma includes the following:[1]
- 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.[1]
- 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.[1]
Pleural Fibromas
- Tends to have soft tissue attenuation on unenhanced scans and show relatively homogenous intense background enhancement on contrast enhanced scans.[1]
- 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.[1]
Chondromyxoid Fibroma
- On computed tomography (CT), mild cortical expansion may be observed, and the lesions have a density greater than fluid throughout.[1]
- 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.[1]
- 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