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Discussion of Fibroma


- See:
         - Soft Tissue Menu
         - Desmoplastic fibroma
         - Fibromatosis

- Discussion:
    - solitary, beinign fibrous tumor of sof tissue;
    - it may occur at any age;
    - lesions arise as a slowly enlarging soft tissue mass;
    - palmer and planter aspects of the hands and feet are common sites of involvement;
    - lesion begins as active stage 2 lesion but then typically becomes latent;
    - treatment:
          - nonoperative treatment should always be tried and exhausted before considerations are made for excision;
          - small lesions are especially amenable to orthotic treatment (insole is cut out over the lesion);
          - excision, when, necessary, must be wide inorder to avoid recurrance (which is common);

- Juvenile Aponeurotic Fibroma:
    - age under 20 years;
    - localized to the hand and wrist more than 50% of the time;
    - usually painless
    - spotty calcification
    - always benign but may be confused with calcification;
    - treatment:
         - excision:
         - high recurrance rate;

- Fibroma of Tendon Sheath:
    - attached to the tendon sheath or nearby structures such as lumbrical;
    - one of the more common fibrous tumors;
    - ages 20-50 yrs;
    - may be found on the palmar surfaces of the hand;
    - clinical diff dx: GCT of tendon sheath;
    - treatment
         - marginal excision, (recurrances have been reported)

           
- Dermatofibroma:
    - not true fibroma, it eneters into differential diagnosis of these firm nodular lesions;
    - benign fibrohistiocytic tumors of dermatofibroma is a common mass involving the skin of many parts of the body;

- Nodular fasciitis:
    - painful pseudosarcomatous, self-limiting reactive process composed of fibroblasts and myofibroblasts;
    - seen in adults who are 20 to 40 years of age;
    - immature-appearing fibroblasts that bear a close resemblance to the fibroblasts found in granulation tissue;
    - fibroblasts are arranged in short, irregular bundles and fascicles and are adjacent to collagen and reticulin