Oral Pathology Department, Faculty of Dentistry, Alexandria University, Champollion Street, Azarita, 21521, Alexandria, Egypt.
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
J Med Case Rep. 2023 Jan 7;17(1):5. doi: 10.1186/s13256-022-03691-2.
Collagenous fibroma or desmoplastic fibroblastoma is a rare benign fibrous tissue tumor. It usually presents as a painless, slowly growing mass. Collagenous fibroma arises ordinarily inside the subcutaneous tissues or skeletal muscles. Histopathologically, the tumor consists of scattered stellate and spindle cells in a hypovascular collagenous stroma without atypia or infiltration. The oral cavity is a very uncommon site for desmoplastic fibroblastoma. Only 15 published articles in the literature reported the intraoral location. We present a case of collagenous fibroma with a bilateral distribution on the hard palate. This is the second case of bilateral collagenous fibroma after a previously reported one in literature; however, our case was larger, occupying almost the whole palate. We discuss the management of this rare tumor and how we can reach definite diagnosis.
A 37-year-old Caucasian female patient had a huge bilateral firm palatal mass that caused breathing problems. There was no history of trauma and the patient had no relevant medical history Total surgical excision under general anesthesia was carried out and histopathological examination suggested a benign mesenchymal tumor. Immunohistochemistry was necessary to confirm the tumor origin and to exclude aggressive fibromatosis. A diagnosis of bilateral collagenous fibroma was reached. Six months after surgery, there was no recurring lesion and the patient's health was good.
Collagenous fibroma is a benign fibrous tissue tumor of unknown cause that is treated with simple excision. The prognosis is good with no recurrence. Reaching an accurate diagnosis is mandatory to avoid aggressive treatment since collagenous fibroma may be misdiagnosed as aggressive fibromatosis in case of massive size. Clinicians and pathologists should be aware of this unusual tumor for conservative management without side effects.
胶原纤维瘤或硬纤维瘤是一种罕见的良性纤维组织肿瘤。它通常表现为无痛、缓慢生长的肿块。胶原纤维瘤通常发生在皮下组织或骨骼肌内。组织病理学上，肿瘤由散布的星状和梭形细胞组成，在无血管胶原基质中，无异型性或浸润。口腔是硬纤维瘤非常罕见的部位。文献中仅报道了 15 篇关于口腔内硬纤维瘤的文章。我们报告了一例硬腭双侧分布的胶原纤维瘤。这是继文献中报道的首例双侧胶原纤维瘤之后的第二例；然而，我们的病例更大，几乎占据了整个硬腭。我们讨论了这种罕见肿瘤的治疗方法以及如何做出明确的诊断。
一名 37 岁的白人女性患者双侧硬腭有巨大的坚实肿块，导致呼吸问题。无外伤史，患者无相关病史。在全身麻醉下进行了全切除手术，组织病理学检查提示为良性间叶肿瘤。为了明确肿瘤来源并排除侵袭性纤维瘤病，需要进行免疫组织化学检查。诊断为双侧胶原纤维瘤。术后 6 个月，无复发病灶，患者健康状况良好。
胶原纤维瘤是一种病因不明的良性纤维组织肿瘤，采用单纯切除治疗。无复发，预后良好。为了避免侵袭性治疗，明确准确的诊断是必要的，因为胶原纤维瘤在体积较大时可能被误诊为侵袭性纤维瘤病。临床医生和病理学家应该意识到这种不常见的肿瘤，以便进行保守管理，无副作用。
