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Collagenous fibroma, also known as desmoplastic fibroblastoma, is a slow-growing, deep-set, benign fibrous tumor, usually located in the deep subcutis, fascia, aponeurosis, or skeletal muscle of the extremities, limb girdles, or head and neck regions.[1]: 605 The World Health Organization in 2020 reclassified desmoplastic fibroblastoma/collagenous fibroma as a specific benign tumor type within the broad category of fibroblastic and myofibroblastic tumors.[2]
| Collagenous fibroma | |
|---|---|
| Specialty | Dermatology |
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]
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 vimentin immunohistochemistry.[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]
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]
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