Fibromas present as hard swellings or lumps that are typically painless. The tumors are well circumscribed and usually immobile.

Associated symptoms depend upon the type of tumor. For example, a fibroma of the oral cavity may also present with dysphagia, slurring of words and impaired speech, etc.

• Pain

  The pain is relieved by rest or weight bearing restriction. [orthopaedicsone.com]

  Over-the-counter pain relief OTC non-steroidal anti-inflammatory drugs (NSAIDs) are another option for people with foot pain. [medicalnewstoday.com]

  Painful fibromas may be treated with an off-loading insole or pad. Surgery is done for symptomatic fibromas when conservative treatment fails to give adequate pain relief. [legacy.aofas.org]

  People who have a plantar fibroma may or may not have pain. When pain does occur, it is often caused by shoes pushing against the lump in the arch, although it can also arise when walking or standing barefoot. [acfas.org]

  Over time his pain increased to the point of requiring opioids for pain control and presenting to our hospital. In the interim, he changed his job and decreased his physical activity, neither of which alleviated his pain. [openorthopaedicsjournal.com]

• Asymptomatic

  Asymptomatic-papillary-fibroelastoma-of-the-Aortic-valve-in-a-young-woman---a-case-report-1476-7120-7-43-S3.ogv 1,1 s, 636 × 432; 405 KB Diseases of the dog and their treatment (1911) (14781852431).jpg 1 514 × 1 432; 307 KB Diseases of women. [commons.wikimedia.org]

  Abstract Cardiac fibroma is a rare disease, and the management of asymptomatic patients is controversial. We report a case of successful surgical excision of a large cardiac fibroma in an asymptomatic child. [ncbi.nlm.nih.gov]

• Swelling

  The lesion is generally asymptomatic until the growth produces a noticeable swelling and mild deformity. Displacement of teeth may be an early clinical feature. [ijdr.in]

  The ectropion deformity in the right lower eyelid improved dramatically with a better facial appearance and no obvious swelling. [ncbi.nlm.nih.gov]

  On examination, the swelling was 7 cm × 7 cm in size extending superiorly till infraorbital margin, medially till ala of the nose and inferiorly above the ramus of the mandible. On palpation, the swelling was bony hard in consistency. [ccij-online.org]

  The swelling was progressive in size and firm in consistency, confined to the anterior mandible on the right side [Figure 1]. She complained of mild pain over the swelling; however she was not finding any difficulty in opening the mouth. [mjdrdypu.org]

  The swelling resolved following the removal of the bi-cortical screws placed at the initial osteotomy. [academic.oup.com]

• Surgical Procedure

  During the surgical procedure, we accidentally dissected the surrounding periosteal tissue of the left transport completely in the process of transport disc preparation and made the disc into a free bone graft. [ncbi.nlm.nih.gov]

  Often, a minimally invasive biopsy is desirable, prior to commitment to any larger surgical procedure. [my.clevelandclinic.org]

  If desired, they can be removed by a simple surgical procedure in which the lump is shaved off. However, many recur after surgery. See smartphone apps to check your skin. [dermnetnz.org]

• Infertility

  Katke RD Search Google Scholar for Katke RD Article Statistics Katke RDOvarian Fibroma in Young Women with Infertility Mimicking Uterine Fibroid.JCR 2016;6:120-123 Katke RDOvarian Fibroma in Young Women with Infertility Mimicking Uterine Fibroid.JCR [ [casereports.in]

  In addition to treatment for a fibroma, patients may consult with physicians and surgeons at the Center about ovarian fibroma, uterine polyps, and endometriosis symptoms and endometriosis treatment, and other conditions related to infertility and reproductive [brighamandwomens.org]

  For those who cannot, infertility treatments may help. NIH: National Institute of Child Health and Human Development Definition (NCI) A benign smooth muscle neoplasm arising from the body of the uterus. [fpnotebook.com]

  Some cases of fibroids can be painful and even cause bleeding and eventually infertility. But typically, the risk of that is quite low. And fibromas can really occur anywhere in the soft tissue of the body. [fibromyalgiatreating.com]

• Dyspnea

  We report a case of right atrial fibroma in a 40-year-old male who presented with dyspnea and atrial fibrillation. [ncbi.nlm.nih.gov]

  The dyspnea was mostly evident upon exertion, and she was unable to climb a flight of stairs without distress. The chest pain occurred in two sites. [journal.chestnet.org]

• Dental Caries

  He had good oral hygiene status with no clinically detectable dental caries and periodontal problems. Vitality of 24, 25, and 26 was unresponsive and fine needle aspiration cytology was negative. [jdas.in]

• Fracture

  In cases of pathologic fracture, complications associated with the fracture (physeal disturbance, angular deformity etc.) are the only potential complications. Holistic medicine Children with benign lesions rarely need any ancillary support. [orthopaedicsone.com]

  Stage B lesions were found to be at an increased risk of fracture, and the age range over which fractures occur was wide. No fractures were detected in the other three stages. [ncbi.nlm.nih.gov]

  If there is a fracture, immobilization in a cast is the treatment of choice with close observation by an orthopaedic doctor. These fractures heal well with a normal amount of callous but the NOF may or may not resolve. [ortho-institute.org]

  This pain may be due to the tumor itself or may be the result of a crack in the bone (pathologic fracture). These minor fractures can occur because an NOF weakens the overall strength of the bone. [orthoinfo.aaos.org]

  […] or other stabilization techniques for frx prophylaxis and treatment Benign fibrous histiocytoma of bone Pathological fractures through non-ossifying fibromas. [wheelessonline.com]

• Arthritis

  We describe the first case of diagnosis of generalized calcifying aponeurotic fibroma in 52 year-old man receiving long-term therapy for seronegative rheumatoid arthritis with rheumatoid nodules. [ncbi.nlm.nih.gov]

  Arthritis Care Res (Hoboken). 2013;65(5):777–785. 4. Mease PJ, Arnold LM, Crofford LJ, et al. Identifying the clinical domains of fibromyalgia: contributions from clinician and patient Delphi exercises. Arthritis Rheum. 2008;59(7):952–960. 5. [dovepress.com]

• Alopecia

  There is alopecia and rare skin ulceration over the tumors. The infected adult rabbit remains clinically normal otherwise. Tumors will typically regress after a period of about 6 months. [dora.missouri.edu]

Workup consists of a detailed history and physical examination.

Laboratory Tests

• Complete blood count
• Tumor growth factors

Imaging Studies

• CT scan to see the extent of growth
• Fine needle aspiration
• Biopsy

Test Results

A detailed physical examination along with imaging studies is sufficient to come to a diagnosis.

Treatment depends upon thy subtype of the fibroma. Intralesional curettage and cementation is an effective treatment strategy for chondromyxoid fibromas, providing satisfactory functional results with a low recurrence rate [9].

Gingival fibromas and plantar fibromas are recommended to be surgically excised. Angiosarcomas are also treated by surgical removal, etc. Aggressive treatment of ameloblastic fibrosarcoma (AFS) including resection with negative margins is the treatment of choice [10].

Fibromas are benign tumors so they have an excellent prognosis. With appropriate treatment, all symptoms can be successfully relieved.

Complications

Complications of fibromas depend on the location and type of tumor. For instance, a gingival fibroma such as POF or giant cell fibroma may obstruct the oral and nasal cavity. Surface ulceration is common [8]. A plantar fibroma may cause chronic heel pain. And like any other benign tumor, there is a chance, no matter how slight, that it may become premalignant or in some extremely rare cases, malignant.

Fibromas are majorly idiopathic. Some, however, are drug induced. For example, some fibromas arising in the gingiva can be the result of chronic use of some drugs. Drug induced gingival overgrowth has been associated with systemic use of phenytoin, cyclosporin and calcium channel blockers [2]. Other causes include familial inheritance and benign overgrowth due to irritants.

Incidence

The exact incidence of fibromas is unknown.

Age

Fibromas can occur at any age. However, they are more common in adults.

Fibromas are connective tissue tumors so they can occur anywhere in the body. They arise from the mesenchyme either due to mutation in the cells or due to irritants, such as plaque in the case of oral cavity fibromas. Histologically, they are unencapsulated, hard, nodular masses of hyalinized connective tissue fibres arranged haphazardly.

Types

The following are the most common type of fibromas:

• Oral cavity fibromas
• Angiofibromas

Oral cavity fibromas

Some subtypes of oral cavity fibromas include:

•  Peripheral ossifying fibroma

Peripheral ossifying fibroma (POF) is a reactive lesion of the gingival tissues that predominantly affects women and is usually located in the maxilla anterior to the molars [3]. Surgical excision is the treatment of choice.

• Other gingival fibromas

Localised overgrowths of the gingiva such as peripheral fibroma, peripheral ossifying/cementifying fibroma, pyogenic granuloma and peripheral giant cell granuloma belong to a common group of lesions designated as focal reactive overgrowths (FROG) [4]. They occur in response to chronic low-grade irritation of the oral mucosa.

Angiofibroma

Soft tissue angiofibroma is a recently described neoplasm that typically presents as a slowly growing, painless mass in the soft tissues of the lower extremities [5]. A t(5;8) translocation has been found associated with it.

Others

• Elastofibroma

Histologically, the elastofibroma consists of collagen fibres and coarse elastic fibres that can be demonstrated by elastin stain [6]. This subtype is fairly uncommon. 

• Sclerotic fibroma

This type is an uncommon benign growth occurring most commonly in the skin either singly or it can be multifocal. The tumor cells are CD34 and vimentin positive [7].

A healthy life style and avoiding use of potentially harmful drugs as well as protection from external irritants may possibly prevent occurrence or recurrence of the tumors.

Fibromas are benign overgrowths of the connective tissue that occur in response to a mutation in the cells. As they are non cancerous, they do not pose serious health risks and can be surgically removed when needed. Recurrence is possible, however, if the offending irritant persists [1].

Definition

Fibromas are non cancerous overgrowths of connective tissues like bone, soft tissues, skin, blood, etc.

Cause

Fibromas are generally idiopathic. Some, like oral cavity fibromas however, may be due to irritants such as chewing beetle nuts, a common practise in many South Asian countries. Others may be due to drug associated growth, familial inheritance predisposing to the condition and genetic mutations.

Symptoms

Patients generally complain of single or multiple painless swelling, associated with regional (area-wise) symptoms.

Treatment

Treatment is surgical excision of the tumor.

Prevention

Fibromas have no definite preventive measures. However, they can be avoided by safe guarding against external irritants and harmful drugs.

1. Esmeili T, Lozada-Nur F, Epstein J. Common benign oral soft tissue masses. Dent Clin North Am. Jan 2005;49(1):223-40, x [Medline]
2. Dongari-Bagtzoglou A. Drug-associated gingival enlargement. J Periodontol. Oct 2004;75(10):1424-31. [Medline]
3. Kale L, Khambete N, Sodhi S, Sonawane S. Peripheral Ossifying Fibroma: series of 5 cases. J Indian Soc Periodontol. 2014 July;18(4):527-30 doi: 10.4103/0972-124X.138762.
4. Parwani S, Parwani RN. Diagnosis and management of focal reactive overgrowths of gingival-a case series. H Mich Dent Assoc. 2014 July;96(7):36-47. PMID 25163184 [PubMed]
5. Lee JJ, Bredella MA, Springfield DS, Neilson GP. Soft tissue angiofibroma: a case report. Skeletal Radiol 2014 March;43(3):403-7. doi: 10.1007/s00256-013-1742-0 PMID 24113908 [PubMed]
6. Lee JH, An JS, Lee ES, Kwon SY, Kim YS. Comparison of sporadic sclerotic fibroma and solitary fibrous tumor in the oral cavity. Yonsei Med J. June 30 2007;48(3):535-9 [Medline].
7. Manchandu R, Foote J, Alawi F. Elastofibroma presenting as an oral soft tissue mass. J Oral Pathol Med. Feb 2008;37(2):125-6. [Medline]
8. Buchner A, Hansen LS. The histomorphologic spectrum of peripheral ossifying fibroma. Oral Surg Oral Med Oral Pathol. Apr 1987;63(4):452-61
9. Bhamra JS, Al-Khateeb H, Dhinsa BS, Gikas PD, Tirabosco T, Pollock RC, Skinner JA, Aston WJ, Saifuddin A, Briggs TW. Chondromyxoid fibroma Management: a single institution experience of 22 cases. World J Surg Oncol. 2014 Sep 12;12(1):283.
10. Wang BY. Head and Neck Pathology:SS13-1 Ameloblastic Fibrosarcoma of Mandible. Pathology. 2014 Oct;46 Suppl 2:S18. doi 10.1097/01.PAT.0000454111.11437.36. PMID 25188081.