Nuchal fibroma
| Nuchal fibroma | |
|---|---|
| Specialty | Oncology |
Nuchal-type
Signs and symptoms
These lesions are generally asymptomatic, although patients give a long history of a solitary, superficial mass. The mass is usually in the
There is a strong association with diabetes mellitus andPathology
The tumors are unencapsulated and poorly circumscribed, showing a firm, white cut surface. Most tumors are about 3.5 cm, but can be up to 8 cm.[1] By microscopic examination, there are haphazardly arranged thick collagen fibers, with a low cellularity and no pleomorphism. There are usually entrapped fat cells, skeletal muscle, and peripheral nerves. The may be perineural fibrosis. The elastic fibers may be altered, which is why an elastofibroma is considered in the differential diagnosis.[1]
Immunohistochemistry
The tumor cells are strongly positive for
Diagnosis
Differential diagnoses
The differential diagnosis includes
Management
Simple excision is curative. However, in patients with Gardner syndrome, up to 45% will develop desmoid-type fibromatosis at other sites, and so this should be searched for and excluded. Patients can develop a recurrence, so follow-up is required.[2]
Epidemiology
This is a rare tumor, presenting over a wide age range, but usually in the third to fifth decades of life. There is a slight male predilection, although this is not seen in syndrome-associated patients. The most common site is the posterior neck, but may also be seen in other sites (extremities, lumbosacral area, buttocks, face).[1]
See also
References
Further reading
Lester D. R. Thompson; Bruce M. Wenig (2011). Diagnostic Pathology: Head and Neck: Published by Amirsys. Hagerstown, MD: Lippincott Williams & Wilkins. pp. 8:44–45.