Clinically, the lesion is observed as a hard, well-circumscribed, lobulated, round to oval, or fibrous mass that has a sparkling gray-to-white aspect and appears fibrous on the cut surface.[3] Patients with these tumors often appear with a history of a painless, slowly developing mass, often over a reasonably lengthy period of time. These tumors are mostly found in the subcutaneous and skeletal muscle tissues of the extremities.[4] These tumors usually have a diameter of 1 to 20 cm, with a median diameter of 3 cm.[5][6]
Diagnosis
Collagenous fibroma is characterized histopathologically by long, sweeping fascicles of uniformly spindled cells that range in size from moderately to hypercellular. Long, thick-walled arteries exhibiting perivascular stromal edema are seen.[7]Gardner fibroma, nuchal-type fibroma, and desmoid tumor are examples of differential diagnoses.[8]
The fibroblastic cells have strong vimentinimmunohistochemistry.[9] A small number of cells may exhibit positive immunoreactivity for alpha-smooth muscle actin and muscle-specific proteins.[6] The cells resemble fibroblasts or myofibroblasts in terms of ultrastructure.[5]
Treatment
Patients with collagenous fibroma who undergo marginal excision have good surgical results.[10] Video-assisted surgery has been suggested as a substitute for traditional open surgery in the removal of tumors on the chest wall because it minimizes tissue damage and allows for a smaller incision.[11][12]
^Hasegawa, T; Shimoda, T; Hirohashi, S; Hizawa, K; Sano, T (May 1998). "Collagenous fibroma (desmoplastic fibroblastoma): report of four cases and review of the literature". Archives of Pathology & Laboratory Medicine. 122 (5): 455–460. PMID9593348.
^ abMiettinen, Markku; Fetsch, John F (1998). "Collagenous fibroma (desmoplastic fibroblastoma): A clinicopathologic analysis of 63 cases of a distinctive soft tissue lesion with stellate-shaped fibroblasts". Human Pathology. 29 (7). Elsevier BV: 676–682. doi:10.1016/s0046-8177(98)90275-1. ISSN0046-8177. PMID9670823.
Kresse, Maxine E.; Kransdorf, Mark J.; Fox, Michael G.; Flug, Jonathan A.; Long, Jeremiah R.; Murphey, Mark D. (2020). "Desmoplastic Fibroblastoma: An Uncommon Tumor With a Relatively Characteristic MRI Appearance". American Journal of Roentgenology. 215 (1): 178–183. doi:10.2214/AJR.19.22163. ISSN0361-803X. PMID32406775.