Multiple nuchal fibromas in a 2-year-old without Gardner syndrome

Nuchal-type Fibroma Induced by Repetitive Trauma from Weightlifting: Case Report and Comprehensive Review of Literature

A nuchal-type fibroma (NTF) is a rare, benign, subcutaneous nodule that most frequently occurs in the posterior neck along the midline. It is characterized histologically by bundles of thick collagen fibers confined to the dermis and subcutaneous tissue of the posterior neck. Few trauma-related NTF cases have been published. We present a biopsy-proven case of NTF that is likely to have developed as a result of weightlifting activity in the gym, including repetitive trauma to the area of the lesion during the exercise known as the "barbell back squat." During this exercise, a heavy barbell was repeatedly rested on the patient's vertebral prominence at the level of C7/T1, the location where the NTF developed. Our 25-year old patient reported that he had been doing this exercise on a weekly basis for about 10 years. We believe that repetitive trauma at this location from specific weightlifting exercises may attribute to the incidence of NTF. A description of key magnetic resonance imaging characteristics and the surgical pathology of this case are provided, along with a review of current literature on trauma-related NTFs.

Nuchal-type Fibroma: Single-Center Experience and Systematic Literature Review

BACKGROUND

Nuchal-type fibroma is a rare benign tumor arising from the connective tissue. Our aim was to present our experience via two cases of this tumor and a comprehensive review of the literature.

PATIENTS AND METHODS

We report a case of a 23-year-old female with a mass located in the posterior neck and the upper back and a case of a 50-year-old male with a mass located in the posterior neck, which were proved to be nuchal-type fibromas in the histopathological examination. We also searched the PubMed/Medline database for published cases of nuchal-type fibromas.

RESULTS AND DISCUSSION

Nuchal-type fibroma is a rare benign tumor arising from the connective tissue, usually in the posterior neck, which affects different ages, with most patients being male. It is a poorly circumscribed tumor consisting of hypocellular, thick, dense and haphazardly arranged collagen bundles with entrapped adipocytes, nerve fibers and muscle fascicles and a few scattered spindle cells, which are CD34 positive. Its excision is curative, and the recurrence risk is generally low. However, patients with Gardner's syndrome may experience recurrence more frequently.

CONCLUSION

Nuchal-type fibroma should be included in the differential diagnosis of subcutaneous, soft-tissue masses, especially when these involve the posterior neck.

Multiple nuchal-type fibromas on the scalp: a case report

Nuchal-type fibroma is a rare, benign, fibrous, tumor-like proliferation characterized by dense hypocellular bundles of collagen, with sparsely scattered fibroblasts, interspersed fat tissue, and entrapped nerve fibers. It usually develops in the posterior neck as a solitary, firm, poorly circumscribed, subcutaneous mass. Herein, we report about a 32-year-old man who presented with a 6-year history of multiple nodules on the scalp. Histopathological features were consistent with those of nuchal-type fibroma. The tumors were surgically excised.