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Bakhshwin A, Oaxaca G, Armstrong S, Ko J, Billings S. Superficial desmoplastic fibroblastoma ( collagenous fibroma): Clinicopathologic study of 11 cases. J Cutan Pathol 2024; 51:70-75. [PMID: 37666661 DOI: 10.1111/cup.14529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/10/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Desmoplastic fibroblastoma (collagenous fibroma) is a rare soft tissue tumor that usually arises in the subcutis or skeletal muscle. Cases superficial to fascia are unusual and can cause diagnostic difficulty. We present 11 cases of superficial desmoplastic fibroblastoma involving a wide anatomic distribution. METHODS Archives were searched using the term "desmoplastic fibroblastoma" over a 10-year period (2012-2022). Cases superficial to fascia were retrieved, and available clinicopathologic features were recorded. Only cases involving the dermis were included. RESULTS Eleven cases were identified, all of which were received in consultation. Tumors involved the head and neck (2), lower extremity (2), back (2), foot (1), shoulder (1), axilla (1), hand (1), and breast (1). Each consisted of a hypocellular proliferation of bland stellate to spindled fibroblasts set in a collagenous to focally myxoid stroma. The immunohistochemical stains available for review demonstrated SMA positivity (4/7) and negative immunoreactivity for CD34 (0/6), EMA (0/3), desmin (0/3), and S100 (0/7). CONCLUSIONS Desmoplastic fibroblastoma may present superficially in the dermis to subcutis, posing a potential source of diagnostic difficulty. Recognition of the characteristic histopathologic features of desmoplastic fibroblastoma with judicial use of immunohistochemical stains should allow for accurate diagnosis.
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Affiliation(s)
- Ahmed Bakhshwin
- King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gabriel Oaxaca
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Susan Armstrong
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jennifer Ko
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Steven Billings
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Almarri FK, Albokashy MS, Alahmadi RM, Alrumeh AS. Desmoplastic Fibroblastoma of the Supraclavicular Region: A Rare Soft-Tissue Tumor With a Review from the Last Decade. Ear Nose Throat J 2022:1455613221123732. [PMID: 36036394 DOI: 10.1177/01455613221123732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
Desmoplastic fibroblastoma (DF) is primarily a sporadic, rare, benign, soft-tissue tumor with an excellent prognosis and no reported recurrence to date. DF presents as a painless, slow-growing mass with symptoms due to its mass effect. We report a case of a middle-aged man presenting with a right supraclavicular mass and numbness of the right arm, eventually diagnosed as DF. After confirming the diagnosis with imaging and biopsy studies, the tumor was successfully excised using a transcervical approach with no complication or recurrence detected during the 2-year follow-up after surgery. A review of the relevant literature is presented regarding the presentation, diagnosis, and outcomes of published case reports of DF coinciding with those of our discussed case. This case report adds to the pool of uncommon DF cases mainly for its unique symptoms and location. It also highlights the necessity of health education related to painless masses that might be attributed as trivial in the community.
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Affiliation(s)
- Firas K Almarri
- College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mohammed S Albokashy
- Head and Neck Surgery Division, Department of Otolaryngology/Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Rawan M Alahmadi
- Head and Neck Surgery Division, Department of Otolaryngology/Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Assem S Alrumeh
- Department of Pathology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Nakayama S, Nishio J, Aoki M, Nabeshima K, Yamamoto T. An Update on Clinicopathological, Imaging and Genetic Features of Desmoplastic Fibroblastoma ( Collagenous Fibroma). In Vivo 2021; 35:69-73. [PMID: 33402451 DOI: 10.21873/invivo.12233] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022]
Abstract
Desmoplastic fibroblastoma (also known as collagenous fibroma) is an uncommon benign fibroblastic/myofibroblastic neoplasm that primarily arises in the subcutaneous tissue of upper extremity. Magnetic resonance imaging reveals a well-defined mass in intimate association with dense connective tissue and prominent low signal intensity on all pulse sequences. Peripheral and septal enhancement is usually seen after intravenous contrast. Histologically, the lesion is paucicellular and consists of spindle to stellate-shaped cells embedded in a collagenous or myxocollagenous stroma with low vascularity. Diffuse and strong nuclear immunoreactivity for FOS-like antigen 1 seems to be characteristic of desmoplastic fibroblastoma. Cytogenetic studies have demonstrated the presence of 11q12 rearrangements and an identical t(2;11)(q31;q12) translocation. This review provides an updated overview of the clinical, radiological, histological, cytogenetic and molecular genetic features of desmoplastic fibroblastoma and discusses the relationship to fibroma of tendon sheath.
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Affiliation(s)
- Shizuhide Nakayama
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Jun Nishio
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan;
| | - Mikiko Aoki
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Murata H, Imai K, Nakagawa K, Nishigaki Y. Multimodal radiological imaging of collagenous fibroma arising from the subacromial region in a patient with osteosarcoma: A case report. Mol Clin Oncol 2019; 10:366-370. [PMID: 30847175 DOI: 10.3892/mco.2019.1798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 12/07/2018] [Indexed: 11/05/2022] Open
Abstract
Collagenous fibroma arising from the subacromial region is extremely rare. It is important to distinguish collagenous fibroma from other fibrous tumors including desmoid tumors, to differentiate between the prognoses and management strategies, including surgical treatment. The present case report describes the case of a 42-year-old man with a collagenous fibroma of the subacromial region. He received a follow-up examination following treatment for osteosarcoma. Positron emission tomography (PET) scans used to assess for metastatic lesions indicated uptake in his left shoulder. The maximum standardized uptake value was 2.4. Magnetic resonance imaging demonstrated iso-intensity to muscle on T1-weighted images and iso-intensity with slightly high intensity on T2-weighted images. Post-contrast fat-suppressed magnetic resonance images indicated slightly heterogeneous enhancement of the lesion. There were no notable results from X-rays, bone scintigraphy and thallium-201 scintigraphy. Histological examination revealed collagenous fibroma. To the best of our knowledge, the present case is only the second incidence of collagenous fibroma arising from the subacromial region, and the first description of thallium-201 scintigraphy and PET scans in collagenous fibroma. The multimodal radiological data of this case may be useful for assisting in the differentiation of fibrous tumor types, including collagenous fibroma.
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Affiliation(s)
- Hiroaki Murata
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Kan Imai
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Kazuya Nakagawa
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Yasunori Nishigaki
- Department of Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
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Hu SCS, Lin CL. Dermal desmoplastic fibroblastoma presenting as a large sacral mass. Australas J Dermatol 2015; 57:296-299. [PMID: 26114246 DOI: 10.1111/ajd.12363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/14/2015] [Indexed: 11/30/2022]
Abstract
Desmoplastic fibroblastoma (collagenous fibroma) is a rare and recently recognised benign tumour. Most desmoplastic fibroblastomas arise in the subcutaneous tissue or skeletal muscle. Involvement of the dermis is extremely rare. We describe an unusual case of dermal desmoplastic fibroblastoma presenting as a large sacral mass in a 16-year-old male. An awareness of this entity is necessary to avoid confusion with other benign and malignant soft tissue neoplasms.
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Affiliation(s)
- Stephen Chu-Sung Hu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Ling Lin
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Zhu Y, Zhang X, Guan X, Wang L. Collagenous fibroma of the right coronary cusp: a case report and literature review. Echocardiography 2014; 32:390-2. [PMID: 25287186 DOI: 10.1111/echo.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Collagenous fibroma (desmoplastic fibroblastoma) is a rare benign tumor. This type of tumor mostly occurs in the subcutaneous tissues or skeletal muscle, and to the best of our knowledge, there is no unique case report of it occurring in the cardiac valves. This is the first description of collagenous fibroma in a human heart.
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Affiliation(s)
- Yanbo Zhu
- Division of Ultrasound, Tianjin Chest Hospital, Tianjin, China
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Nishio J, Iwasaki H, Nagatomo M, Naito M. Fibroma of tendon sheath with 11q rearrangements. Anticancer Res 2014; 34:5159-5162. [PMID: 25202108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Fibroma of tendon sheath is an uncommon, benign fibroblastic tumor that usually occurs in the upper extremities of young and middle-aged adults. A clonal chromosomal aberration, t(2;11)(q31-32;q12), has been described in one case. We herein present a unique cytogenetic finding of fibroma of tendon sheath arising in the first web space of the right hand of a 38-year-old woman. Physical examination showed a 3.5-cm, firm, mobile, non-tender mass. Magnetic resonance imaging showed a well-defined soft tissue mass with iso- to slightly-low signal intensity relative to skeletal muscle on both T1- and T2-weighted sequences. Contrast-enhanced T1-weighted sequences demonstrated moderate patchy enhancement of the mass. A fibroma or giant cell tumor of tendon sheath was suggested, and the lesion was marginally excised. Histological examination confirmed the diagnosis of fibroma of tendon sheath. Cytogenetic analysis revealed a novel t(9;11)(p24;q13-14) translocation among other karyotypic abnormalities. The postoperative course was uneventful, and the patient is doing well without local recurrence two months after surgery. To the best of our knowledge, this is only the second report of fibroma of tendon sheath with clonal chromosomal abnormalities.
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Affiliation(s)
- Jun Nishio
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hiroshi Iwasaki
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masaya Nagatomo
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masatoshi Naito
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Gao S, Cai Q, Yao W, Wang J, Zhang P, Wang X. Desmoplastic (collagenous) fibroma of the femur: A case report and review of the literature. Oncol Lett 2013; 6:1285-1288. [PMID: 24179509 PMCID: PMC3813691 DOI: 10.3892/ol.2013.1535] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 07/31/2013] [Indexed: 11/14/2022] Open
Abstract
Desmoplastic fibroma is a rare, benign soft-tissue tumor composed of spindled and stellate-shaped cells that are embedded in a dense collagenous stroma. Clinically, desmoplastic fibroma presents as a firm, mobile, slow-growing mass that is located in the subcutaneous tissue or near the deep aspect of the skeletal muscles. The present study describes the case of a 66-year-old female who presented with an inactive, firm, slightly tender mass in the lower medial segment of the right femur. An open biopsy was performed and the result of the pathological examination indicated a desmoplastic fibroma. The patient underwent a radical resection of the tumor and the accompanying bone, which was then reimplanted using devitalized tumor bone, self-ilium graft and homologous allograft bone transplantation, with an internal fixation by locking the compression plate. This was followed by a reconstruction of the anterior and posterior cruciate ligaments and the lateral and medial collateral ligaments. There was no evidence of local recurrence at five years post-surgery.
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Affiliation(s)
- Songtao Gao
- Department of Orthopedics of Henan Tumor Hospital, The Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
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Nagaraja V, Coleman HG, Morgan GJ. Desmoplastic fibroblastoma presenting as a parotid tumour: a case report and review of the literature. Head Neck Pathol 2013; 7:285-90. [PMID: 23504494 DOI: 10.1007/s12105-013-0435-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/11/2013] [Indexed: 10/27/2022]
Abstract
Desmoplastic fibroblastomas (DFs) are rare fibrous soft tissue tumours that usually arise in subcutaneous tissue or skeletal muscle in a variety of anatomical sites. These lesions most frequently present as painless, slow-growing mobile masses. A case of DF is described in a 47-year-old man who presented with a painless right parotid mass of 2 months duration. At surgery, the lesion was attached to the tail of the right parotid gland. Histopathological examination demonstrated a fibrous lesion comprising spindled and stellate shaped fibroblasts with focal myxoid stromal change. The features were consistent with a DF. This report documents a rare parotid lesion which may mimic other more common parotid gland neoplasms.
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Abstract
Collagenous fibroma (desmoplastic fibroblastoma) is a distinctive yet uncommon fibrous soft tissue tumor. These tumors are rather nondescript in their morphological appearance and have been diagnosed as fibromas or some other benign mesenchymal lesions for years. The most common sites are the upper extremities, followed by the lower extremities. Rare lesions arise in the head and neck region. We report a rare case in the oral cavity and present its unique histopathological features (central fat entrapment) besides others, and diffusely strong vimentin immunopositivity.
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Affiliation(s)
- Sanjay Bhagalia
- Department of Oral Pathology, NIMS Dental College, NH 8, Jaipur, Rajasthan, India
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de Sousa SF, Caldeira PC, de Mattos Camargo Grossmann S, de Aguiar MCF, Mesquita RA. Desmoplastic fibroblastoma ( collagenous fibroma): a case identified in the buccal mucosa. Head Neck Pathol 2011; 5:175-9. [PMID: 21221866 PMCID: PMC3098328 DOI: 10.1007/s12105-010-0239-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 12/22/2010] [Indexed: 10/18/2022]
Abstract
Desmoplastic fibroblastoma is a rare, benign, soft tissue tumor affecting mainly the subcutaneous and muscle tissue. Only five cases identified in the oral cavity have been reported in prior literature. This article presents a case report of a 56-year-old man, with no previous history of trauma, who presented a slow-growing mass in the buccal mucosa. Histopathology and immunohistochemistry staining studies were performed, and a diagnosis of the desmoplastic fibroblastoma was made. The patient has been disease-free for one year.
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Affiliation(s)
- Sílvia Ferreira de Sousa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Patrícia Carlos Caldeira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Soraya de Mattos Camargo Grossmann
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Maria Cássia Ferreira de Aguiar
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
- Faculdade de Odontologia, Departamento de Clínica, Patologia e Cirurgia Odontológicas, Universidade Federal de Minas Gerais, Av.: Antônio Carlos, 6627, Sala 3202-D, Pampulha, 31.270-901 Belo Horizonte, Minas Gerais Brazil
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