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We describe a 44-year-old man with fibroma of tendon sheath. The tumor originated in the foot and developed an ulcer during its course. It was totally excised, and the defect was reconstructed by full-thickness skin graft. The patient has been free of any recurrence during the follow-up period of one year. Fibroma of tendon sheath rarely occurs in the foot, and, to our best knowledge, this condition with ulceration is the first case reported.
Calcifying aponeurotic fibroma is a rare type of benign tumor that occurs most commonly in the distal extremities of young children. Due to its infiltrative growth, it has a high tendency of recurrence. Although the clinicopathological features of over 100 cases of this rare disease have been reported, its clinical and radiological features have yet to be described in detail. We present a case of calcifying aponeurotic fibroma of the knee from birth with radiological images, that demonstrate the peculiar features of this uncommon benign tumor and discuss its clinicopathological features based on computed tomography and magnetic resonance images.
An ultrastructural and histochemical analysis was made of a lesion identified by light microscopy as a non-ossifying fibroma of bone. A histogenetic sequence was traced from spindle-shaped fibroblast-like cells to multivacuolated lipoblasts with abundant glycogen. These lipid-laden cells showed remarkable similarity to some cells of a well differentiated liposarcoma. Others have interpreted the lipid-containing cells of non-ossifying fibroma as representing fibroblasts which have imbibed or synthesized lipid or lipid-laden macrophages. Our studies demonstrate that this tumour consists of primitive mesenchymal cells with partial maturation to early lipoblasts, suggesting its classification as a benign lipoblastoma of bone.
A case of giant cell fibroma of the oral mucosa found in a 3-year-old female is reported. The lesion was characterized histologically by the presence of numerous large stellate cells and multinucleated giant cells scattered in a loosely arranged collagen-background. The large stellate cells had a large hyperchromatic nucleus, while the cytoplasm was well demarcated and frequently the cells had dendritic-like processes. The multinucleated giant cells had similar morphology and occasionally resembled Langhans' giant cells. Ultrastructural examination suggested that the multinucleated giant cells in the lesion were unusual fibroblasts. This is the first reported case of oral giant cell fibroma in a Japanese patient.
A 63-year-old Chinese man with a solitary sclerotic fibroma on the abdomen is described. Skin biopsy showed a well-demarcated dermal nodule composed of hypocellular, eosinophilic collagen bundles separated by prominent clefts. Retrospective electron microscopic study revealed wide collagen bundles containing tightly packed collagen fibrils, only 50 nm in diameter. There were no signs of Cowden's disease. To our knowledge, this is the first report of electron microscopic study of sclerotic fibroma. A brief review of the literature is included.
Five lesions were studied to elucidate the histogenesis of cartilage in peripheral fibromas. Cytological features suggested direct transformation from fibroblast-like cells to chondrocytes (cartilaginous metaplasia). Supportive evidence for such differentiation was the presence of neutral and acid mucopolysaccharides in the loose stroma of the lesions as well as in the ground substance of the cartilaginous centers. In one instance, the metaplastic cartilage showed bone formation. An increased number of oxytalan fibers could be demonstrated in the fibroma and in the cartilage.
Clinical, radiographic and microscopic features of 8 ossifying fibromas diagnosed in 7 patients and measuring more than 8 cm in greatest diameter, were reviewed. The tumors occurred in both juvenile and middle aged patients and all lesions in women involved the maxilla. The abundance of fibrous connective tissue and resorption of mineralized deposits are indicative of altered cellular differentiation and proliferative activities in large ossifying fibromas. Focal areas of aneurysmal bone cyst formation were identified in the majority of lesions.
An adult man with systemic mastocytosis developed multiple fibromas within his involved skin, predominantly in the intertriginous areas. Friction in the intertriginous areas and scratching due to severe itch may have induced the release of mast cell factors which subsequently resulted in fibroma formation.
The cemento-ossifying fibroma is classified as an osteogenic neoplasm of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. A case of a large cemento-ossifying fibroma involving the left mandible is described in a 15 year old male patient. The clinical, radiographic and histological features as well as surgical findings are presented. The treatment of choice of this lesion is also emphasized. Two years after surgery, there was no evidence of recurrence and the transosseous wire used to immobilize the fracture was found to be completely buried in the jaw bone.
Degenerate oligonucleotide probes corresponding to a highly conserved region common to epidermal growth factor, transforming growth factor alpha, and vaccinia growth factor were used to identify a novel growth factor gene in the Shope fibroma virus genome. Sequence analysis indicates that the Shope fibroma growth factor is a distinct new member of this family of growth factors.
Seven cases of recurring digital fibroma were seen over a 35-year period. All demonstrated the classical clinical, macroscopic, and microscopic features of this distinct tumour, including the pathognomonic round, eosinophilic cytoplasmic inclusion bodies. Ultrastructurally, all seven cases were confirmed to be myofibroblastic in nature, and the morphology and intracellular topography of the inclusion bodies suggested their derivation from contractile protein. These findings establish recurring digital fibroma as a neoplastic lesion of the myofibroblast.
True nevi and nevoid disorders are defined as visible, circumscribed and long-lasting lesions of the skin, reflecting genetic mosaicism. We report on a 17-year-old young man presenting with large pedunculated soft fibromas restricted to a circumscribed area of the right abdomen. We suggest that these nevoid bag-like soft fibromas represent a new malformation in the heterogenous group of nevoid tumors.
Nuchal fibroma, or collagenosis nuchae, is a benign soft tissue tumor that arises from the posterior cervical subcutaneous tissue, with a predilection for the interscapular and paraspinal regions. Because of its benign clinical course and its close histopathologic similarity to other benign head and neck lesions, this lesion may be misdiagnosed and underreported. The purpose of this paper is to review the histopathologic and radiologic findings unique to nuchal fibroma, and compare and contrast it to the other soft tissue neoplasms within the clinical differential diagnosis. These include several benign (elastofibroma, lipoma, fibrolipoma, nodular fasciitis) and rare malignant entities (fibrosarcoma, liposarcoma, fibromatosis).
Case of a 4-year-old boy with a desmoplastic fibroma of the mandible. Desmoplastic fibromas are benign fibrous neoplasms which are easily confused with other fibrous tumors. Although benign, they usually display aggressive local tissue extension and frequently recur when treated conservatively. At the present time, wide, local excision appears to be the treatment of choice.
We compared the expression of target genes of Hedgehog/Patched signaling in ovarian fibromas and ovarian dermoids. We noted that high levels of SHH appear almost regularly, especially in dermoids, usually accompanied by increased expression of SMO. GLI overexpression does not coincide with that of PTCH. Loss of heterozygosity findings in the PTCH locus and increased expression of several genes in the pathway strongly suggest that the pathway is involved in both ovarian fibroma and dermoids.
We report a case of ossifying fibroma involving the paranasal sinuses, orbit, and anterior cranial fossa. Ossifying fibroma is a benign fibro-osseous tumor, rarely involving the anterior cranial base. The patient was admitted because of exophthalmos and diplopia. The lesion was totally removed surgically. Grossly, it had a thin osseous capsule. The microscopic examination showed mainly fibrous tissues and lamellar bone trabeculae rimmed by osteoblasts and myxomatous areas in some parts. The histopathological aspect of this entity is discussed with reference to the differential diagnosis from monostotic fibrous dysplasia.
Cellular meshworks and topography of gerbil fibroma cells can be preserved by gentle extraction procedures using Triton X-100. We determined the stability and specificity of these cytoskeletal frameworks by measuring extraction rate and its sensitivity to exogenous protein. Two buffers were used, which mimicked the intracellular and extracellular ionic environments. With both buffers, extraction was nearly complete at 5 min. This pattern of extraction was seen both in 5- and 9-day-old cultures. The same pattern of extraction was seen when three different dilutions of cells were examined the second day after plating. Thus, extraction rate was largely independent of minor variations in ionic composition, age in culture, or cell density. Specificity of the cytoskeletal frameworks so produced was determined by competition with two different exogenous proteins (bovine serum albumin or ovalbumin), which did not remove any additional material from the cytoskeletal frameworks, even with over 10% exogenous protein in the extraction buffer. This pattern of extraction is not unique to gerbil fibroma cells. A similar pattern of extraction was seen for a series of cells: mouse 3T3 cells, 3T6 cells and SVPY 3T3 cells. These experiments indicate that the cytoskeletal framework produced by Triton extraction under appropriate conditions is stable after extraction for a period of 10 min or longer, and that the structures are specific, in that they are not disrupted by the presence of exogenous proteins.
Congenital subglottic fibroma is a rare clinical entity. A review of references did not disclose any previous report. A case of congenital subglottic fibroma is presented. Embryology, etiology, symptomatology and pathology of congenital anomalies of the larynx are reviewed and management discussed.