Elastofibroma presenting as an oral soft tissue mass

Identification of elastofibroma and elastofibroma-like lesions in cases diagnosed as oral fibromas

We investigated elastofibromas (EF) and elastofibroma-like structures (EFL) in 95 cases that had been diagnosed as oral fibromas (OF). Histological sections were stained with Verhoeff-Van Gieson, Congo red and hematoxylin and eosin to enable possible reclassification to EF or EFL, or to retain the diagnosis of OF. To do this, we identified amyloid and used histopathological descriptions and epidemiological clinical profiles. We found 56 EF and 21 EFL cases, while 18 diagnoses of OF were retained. We observed a predilection for EF in females. Also, the most common site for OF was the cheek mucosa. We also found a longer time course for lesion development for OF compared to the other lesions. We found a relation between elastic fibers and amyloid material in EF. We also observed perivascular fibrotic lesions (PVFL) in EF. Most cases of EF exhibited more elastic fibers, thicker fibers, stronger relation with amyloid material deposition, rare evidence of PVFL and a longer time course for development compared to the other lesions. We suggest that EFL may give rise to oral EF.

Intraoral epidermoid cyst with extensive elastofibromatous changes: an unusual finding

INTRODUCTION

Epidermoid cysts (ECs) are rare and occur in the head and neck regions with an incidence from 1.6 to 7% of all cysts. In the oral cavity, approximately 80 ECs have been reported, representing less than 0.01% of all cysts.

CASE REPORT

We report a case of a 26-year-old man who developed a large EC in the midline floor of the mouth causing nodular swelling in the submental region and speech and swallowing difficulties. The lesion was surgically excised by intraoral approach and microscopically revealed an EC associated with extensive elastofibromatous changes in the cystic capsule.

CONCLUSION

Oral EC with extensive elastofibromatous changes is a finding extremely rare. The meaning of this finding is unknown, but a traumatic origin or deposit disorder of elastic fibers is suggested. To the best of our knowledge, intraoral EC with elastofibromatous changes has not been reported to date.

Oral elastofibromatous lesions: a review and case series

Elastofibromas of the oral cavity are rare, with only 5 cases reported. In this paper, we present a series of five new cases of oral elastofibromatous lesions, occurring in 4 males and 1 female, with ages ranging from 33 to 76 years. The clinical differential diagnosis includes fibroepithelial polyp or fibroma, among other connective tissue tumours. Elastofibromas probably develop as reactive lesions, for which surgical treatment is definitive.

Elastofibromatous changes and hyperelastosis of the oral mucosa

Three cases of abnormalities of elastic fibers, two of them on the floor of the mouth and one on the lingual alveolar mucosa, close to the floor of the mouth, in a patient with history of homolateral squamous cell carcinoma of the floor of the mouth, are presented. Comparison with elastofibromatous changes and elastofibromas are made and their possible pathogenesis is discussed. It is suggested that increased awareness may facilitate recognition of such lesions as they can be easily overlooked, especially when they do not present as discrete tumors or they are associated with other "more significant" pathologic processes.