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Multiple lower limb non-ossifying fibromas in siblings with neurofibromatosis.

Non-ossifying fibromas are common benign lesions of tubular long bones. There is recognized association of these bony lesions with neurofibromatosis type 1 although the presence of non-ossifying fibromas in familial members with the condition has not previously been reported. We report two siblings with neurofibromatosis and radiological evidence of multiple lower limb non-ossifying fibromas. Both patients presented with pain in the knees and a pathological fracture was observed in one case. Patients with multiple non-ossifying fibromas should be examined carefully for other evidence of neurofibromatosis.

Adolescent↗

Chondromyxoid fibromas of the neurocranium.

We report a case of a chondromyxoid fibroma involving the upper clivus in a 73-year-old man. Chondromyxoid fibromas are uncommon benign bone tumors that rarely involve the skull. Chondromyxoid fibromas arising in the membranous neurocranium resemble their extracranial counterparts, appearing as radiolucent lesions with sclerotic margins and presenting most often as a painless focal swelling. Chondromyxoid fibromas arising in the chondrocranium differ from their extracranial counterparts and from those arising in the membranous neurocranium. They appear as locally destructive, often calcified, and exophytic lesions without sclerotic margins and present with cranial nerve dysfunction and symptoms caused by central nervous system compression.

Journal Article↗

Soft tissue implantation of chondromyxoid fibroma.

While chondroblastoma, a usually benign cartilaginous bone tumor that has histologic features in common with chondromyxoid fibroma, can invade or be accidentally implanted in the soft tissues, it is less well known that this may also occur with chondromyxoid fibroma. A patient is described in whom a chondromyxoid fibroma recurred in the superficial soft tissues following prosthetic replacement of the upper femur. This is only the second such case reported without a simultaneous recurrence within the adjacent bone. The close association of the soft tissue tumor with suture fragments is taken as evidence for implantation at the time of operation. A unique histologic feature was the presence of vascular invasion within the implant. The literature on soft tissue involvement by chondromyxoid fibroma is reviewed and the meaning of this in terms of malignancy is discussed.

Adult↗

Granular cell peripheral odontogenic fibroma.

A case of a peripheral odontogenic fibroma which contained aggregates of large granular cells is reported. These granular cells are similar to those previously described in the granular cell myoblastoma, congenital epulis and the granular cell ameloblastic fibroma. Deep extensions of the basal layer of overlying gingival epithelium, in double-strand fashion, are frequently observed in peripheral odontogenic fibromas. These strands closely resemble those seen in the tumor itself. On this basis, and as similar basal cell prolongations are seen in otherjaw lesions, it is postulated that residual ectomesenchymal influence may be responsible for inducing the basal cell proliferations in a similar manner to that which occurs during early embryonic dental development. This, it is suggested, might possibly be the histogenesis of the odontogenic epithelial strands in the peripheral odontogenic fibroma.

Adult↗

Demonstration of cytotoxic antibodies in rabbits bearing tumors induced by Shope fibroma virus.

The (51)Cr-release test was used to detect cytotoxic antibodies in adult rabbits bearing tumors induced by Shope fibroma virus. The following are the recommended experimental conditions: the infection of RK-13 cells with a multiplicity of 1 to 2 infectious units per cell for 48 hr, (51)Cr labeling of infected cells during the last 12 hr of incubation, sensitization of suspended labeled infected cells for 1 hr with immune serum, and quantitation of cell damage by the amount of (51)Cr released after 6 hr of incubation in the presence of complement. The immune sera reacted only with fibroma virus-infected cells but not with cells infected with vaccinia virus or herpesvirus type 1. Similarly, sera prepared against vaccinia virus and herpesvirus type 1 were not cytotoxic to fibroma virus-infected cells, although they were cytotoxic to cells infected with homologous viruses. The total antibody activity in sera of rabbits infected with Shope fibroma virus was detected first on day 7, gradually rose to its peak by day 23, and persisted at that level for at least 50 days. The 19S antibody was detected on day 7, reached peak titers by day 13, and disappeared by day 17. The 7S antibody was barely detectable on day 7, reached maximum titers on day 13, and remained high for at least 50 days. The tumors appeared on the 3rd day after virus inoculation, reached maximum size on day 13, and regressed completely by day 23.

Animals↗

Chondromyxoid fibroma: radiographic appearance in 38 cases and in a review of the literature.

Thirty-eight cases of histologically confirmed chondromyxoid fibroma were reviewed and their radiographic features recorded. These findings, coupled with a review of the English-language medical literature, suggest that this rare, benign bone tumor has a characteristic but not specific radiographic appearance and may often mimic more common tumors. Chondromyxoid fibroma may occur anywhere in the skeleton, but almost half of the cases occur around the knee. The possibility of chondromyxoid fibroma should always be considered when a focal bone lesion is evaluated that has geographic bone destruction, a sclerotic rim, lobulated margins, and septation. The diagnosis of chondromyxoid fibroma is most likely when the patient is in the 2nd decade of life.

Adolescent↗

Nonossifying fibroma: characteristics at MR imaging with pathologic correlation.

PURPOSE: To correlate the findings of nonossifying fibroma at magnetic resonance (MR) imaging with those at pathologic examination. MATERIALS AND METHODS: In 19 patients (age range, 8-25 years; mean age, 14 years) with pathologically proved nonossifying fibroma, MR images were analyzed for signal intensity and patterns of contrast enhancement. Findings at MR imaging and biopsy were correlated. RESULTS: On T1-weighted images, all nonossifying fibromas had low signal intensity compared with that of skeletal muscle. On T2-weighted images, 15 lesions (79%) were hypointense and four (21%) were hyperintense. On gadolinium-enhanced images, intense contrast enhancement was seen throughout 15 lesions (heterogeneous pattern in 12 and homogeneous in three) and in the margins and septa in four. Extensive hypercellular fibrous tissue and hemosiderin seen at pathologic examination were depicted with low signal intensity on T2-weighted MR images. CONCLUSION: The distinguishing features of nonossifying fibroma included hypointensity and septation on T2-weighted images. Signal intensity on T1- and T2-weighted MR images and the patterns of contrast enhancement were dependent on the amounts of hypercellular fibrous tissue, hemosiderin, hemorrhage, collagen, foamy histiocytes, and bone trabeculae.

Adolescent↗

[Plaque variant of trichoblastic fibroma].

BACKGROUND: Tricoblastic fibroma is a rare benign skin tumor originating in the hair follicle. There are two clinical presentations: nodular and plaque variants. The plaque variant is almost exclusively located on the face with deep tissue infiltration. CASE REPORT: A 38-year-old man presented with a 2 cm diameter cutaneous plaque located on the right cheek. It had first been noted by the patient 3 years earlier and had enlarged slowly. On examination, the plaque was well defined, yellowish and slightly indurated. The first clinical diagnosis was basal cell carcinoma and the plaque was removed. Histology provided the diagnosis of trichoblastic fibroma. The patient remains well, with no evidence of recurrence, 10 months after excision. DISCUSSION: Trichoblastoma is an inclusive term for all benign cutaneous neoplasms that are mostly composed of follicular germinative cells. According to Altman, the plaque variant of trichoblastic fibroma is a poorly circumscribed neoplasm, particularly at its lateral and deep margins. This author also states that mitotic figures are more numerous in the plaque variant of trichoblastic fibroma and considers this clinical variant as a low-grade follicular malignancy.

Adult↗

Case report: chondromyxoid fibroma arising at the clavicular diaphysis.

This report presents an extremely rare case of chondromyxoid fibroma arising at the clavicle. To the best of our knowledge, this may be the first case report demonstrating in detail the clinicopathological findings of chondromyxoid fibroma at the clavicle. The patient was a 34-year-old housewife. Radiography and CT demonstrated an osteolytic lesion with cortical thinning and expansion with partial destruction at the diaphysis of the left clavicle. MRI showed a homogeneous iso-signal intensity mass in T1-weighted imaging and a heterogeneous high-signal intensity in T2-weighted imaging. Histological findings of the widely resected tumor were consistent with chondromyxoid fibroma. The pre-operative diagnosis of chondromyxoid fibroma at an unusual location, as in this case, is difficult from the imaging examinations, or sometimes even from the histological examination of biopsy materials.

Adult↗

[Uterine fibromas and infertility].

Fibromas is relatively common in the patients in reproductive age and is exclusively responsible for infertility and abortions in 5% of the patients. Approximately 50% of the women with infertility and myomas become pregnant after myomectomy. The evidence suggests most of women who wish to become pregnant are able to do it in the first year, with a fall of these rates after this time. This can be attributed to the recurrence of fibromas. The site, number and size of myomas as well as the experience of the surgeon along with the preference of the patient can influence the management option. They are indications to make surgery in a woman who is considering the possibility of pregnancy by the natural methods or attended reproduction the presence of submucous or intramural fibroid that distorts the uterine cavity, fibromas greater of 3 cm. and manifold fibromas.

Female↗

[A giant chondromyxoid fibroma originated from the right orbital roof.--A case report--].

The authors reported a case of giant chondromyxoid fibroma of the right anterior cranial fossa, arising from the right orbital lamina of frontal bone. A fifteen-year-old boy was admitted because of a recent history of the right exophthalmus and headache. Neurological examination was essentially negative except papilledema in the both optic fundi and the right olfactory disturbance. Skull plain x-ray films showed the bony destruction of the right supraorbital bone and the some of abnormal calcification in the right anterior cranial fossa. CT scan showed cystic low density spots surrounded by irregular ring-like high density areas in the right anterior cranial fossa. Operation was performed on two stages and the tumor was removed totally. The tumor was arising from the orbital lamina of the frontal bone. The size of resected tumor was 7x5x4 cm. The pathological examination confirmed the diagnosis of chondromyxoid fibroma. Postoperatively, the patient is fully schooling without any disturbance 2 years and 7 months after the discharge. In Japan, two cases of intracranial chondromyxoid fibroma have been reported in literature. The authors discussed the histology of chondromyxoid fibroma and the genesis of the membraneous bone origin of the intracranial chondromatous tumor.

Adolescent↗

Intracranial chondromyxoid fibroma. Report of a case and review of the literature.

Chondromyxoid fibroma is an unusual benign tumor of cartilaginous derivation. We describe a rare example of chondromyxoid fibroma of the frontal-sphenoid junction with orbital infiltration in a 35-year-old Hispanic woman who presented with frontal headaches. Gross total excision was performed. The excised mass was composed of neoplastic cells with chondrocytic features within a myxoid matrix. Bony infiltration was present without infiltration of dura mater or brain tissue. The lack of mitotic activity, low cell density, lack of nuclear pleomorphism, and a fused lobular architectural pattern indicated that the lesion was a chondromyxoid fibroma. The lack of hyaline cartilage helped differentiate the lesion from enchondroma. Our case demonstrates the uncommon occurrence of intracranial chondromyxoid fibroma with orbital infiltration. When faced with an intracranial chondrocytic tumor, it is important to distinguish this neoplasm from enchondroma and chondrosarcoma.

Adult↗

Collagenous fibroma (desmoplastic fibroblastoma): a clinicopathologic analysis of 63 cases of a distinctive soft tissue lesion with stellate-shaped fibroblasts.

Sixty-three cases of collagenous fibroma (desmoplastic fibroblastoma) from the files of the Armed Forces Institute of Pathology were analyzed. These tumors occurred mostly in men (80%) with a median age of 50 years (range, 16 to 81 years). The lesions had a wide anatomic distribution and involved the arm (24%), shoulder girdle (19%), posterior neck or upper back (14%), feet or ankles (14%), leg (14%), hand (8%), and abdominal wall and hip (6%). The patients typically presented with a history of a painless, slowly growing mass, often of relatively long duration. The tumors ranged in size from 1 to 20 cm (median, 3.0 cm). The lesions were predominantly subcutaneous, but fascial involvement was common, and 27% of cases involved skeletal muscle. Gross examination typically showed an elongated, lobulated, or disc-shaped mass with a firm consistency and a homogeneous pearl-gray color. Histologically, the tumors often appeared well marginated on low-power examination, but most (78%) infiltrated fat or, less commonly, skeletal muscle. The lesional cells were relatively bland stellate and spindle-shaped fibroblasts separated by a collagenous or myxocollagenous matrix. Mitotic activity was absent or minimal. Some of the lesional cells had a myofibroblastic immunophenotype, as evidenced by focal reactivity for muscle-specific and alpha-smooth muscle actins. In a few cases, rare actin-positive cells were also positive for keratins. Desmin, S100 protein, and CD34 were not expressed. None of the 39 patients with follow-up (median, 11 years) developed a recurrence. Collagenous fibroma is a benign fibroblastic/myofibroblastic proliferation. The large size of some of these tumors coupled with slow growth and persistence favors a neoplastic process over a peculiar reactive proliferation. The differential diagnosis includes a variety of reactive and neoplastic fibroblastic lesions, most importantly fibromatosis and low-grade fibromyxoid sarcoma. Simple, conservative excision is the treatment of choice for collagenous fibroma.

Adolescent↗

An infectious cutaneous fibroma of the Virginia whitetailed deer (Odocoileus virginianus).

A naturally occurring cutaneous fibroma of deer has proven to be experimentally transmissible in deer. The causative agent is a virus that is readily alterable through Berkefeld N candles and that survives in fibroma tissue for at least as long as 27 months in glycerol-saline at -20 degrees C. The experimentally produced deer fibroma has an incubation period of about 7 weeks, a very slow rate of growth, and a high regression rate.

Animals↗

Primary extraosseous cemento-ossifying fibroma of the auricle.

BACKGROUND: A mass of the auricle is uncommon. An enlarging lesion may be the result of a reactive process, or a benign or malignant neoplasm. The literature is reviewed, and a case of extraosseous cemento-ossifying fibroma of the auricle is presented. METHODS: A 22-year-old white man presented with a 3-month history of an enlarging 2 cm mass in the right concha cavum. An incisional biopsy demonstrated cemento-ossifying fibroma. The lesion was resected en bloc, and the patient did well. There is no evidence of recurrence. RESULTS: Pathological examination of the excised mass revealed a well-circumscribed but unencapsulated spindle cell lesion with foci of osteoid and cementum deposition. It did not involve the auricular cartilage, and there was no connection with the overlying epidermis. CONCLUSIONS: This is a case report of an extraosseous cemento-ossifying fibroma of the auricle. This benign tumor should be completely excised because local recurrence may otherwise result.

Adult↗

Intracardiac fibroma in an asymptomatic infant.

Primary tumors of the heart are rare in infancy and childhood. A one-year-old, asymptomatic, male infant with unimpressive physical findings in whom an echocardiogram demonstrated a large, encapsulated, solid fibroma filling the right ventricle without obstruction of either the inflow or outflow tract is presented. Successful complete surgical excision of the tumor was accomplished. The histological examination was compatible with a benign fibroma. The infant has remained asymptomatic postoperatively with subsidence of the heart murmur. He has not shown any evidence of recurrence of the tumor during a follow-up period of 29 months. This represents an unusual case of a huge right ventricular fibroma and only the fifth youngest patient, to our knowledge, to undergo successful surgical removal.

Echocardiography↗

Calcifying aponeurotic fibroma features seen on fine-needle aspiration biopsy: case report and brief review of the literature.

Calcifying aponeurotic fibroma is a rare benign soft tissue proliferation, which occurs in the distal extremities in children. We describe a case of calcifying aponeurotic fibroma of the hand in a 9 year-old male diagnosed by FNA. Clinically and radiographically this mass was felt to be suspicious for sarcoma, likely alveolar rhabdomyosarcoma. Cytologic examination revealed benign appearing spindled cells, chondroid cells, multinucleated giant cells and calcific debris. These features recapitulate the classic histologic features of calcifying aponeurotic fibroma. Conservative excision was performed and histologic exam confirmed the diagnosis. To the authors' knowledge, this is the first description of the cytologic features of this entity.

Biopsy, Needle↗

Fibroma of tendon sheath.

Three cases of fibromas involving tendon sheath of right index finger, left ring finger, and tibial ligament in a 62-, a 54-, and a 30-year-old male patients, respectively, are described. Two cases (1 and 2) represented painless, slowly enlarging masses that limited motion of the involved digits. The third case was discovered at surgery during the repair of a tibial ligament after a motorcycle accident. Following surgical excisions, no recurrences were present 18 months and 9 months after resection. The fibromas of tendon sheath origin are distinct entities and should be separated from other lesions of tendon sheaths. Trauma should be considered as the etiology. The fibromas are benign lesions but may recur.

Adult↗