Fibroma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Oral fibroma must be differentiated from squamous papilloma, giant cell fibroma, neurofibroma, peripheral giant cell granuloma, mucocele, and benign and malignant salivary gland tumors. Non-ossifying fibroma must be differentiated from fibrous cortical defect, aneurysmal bone cyst, chondromyxoid fibroma, fibrous dysplasia, desmoplastic fibroma, giant cell tumour of bone, and spindle cell lesions of bone. Ossifying fibroma must be differentiated from ossifying fibroma, fibrous dysplasia, adamantinoma, and osteoid osteoma. Chondromyxoid fibroma must be differentiated from aneurysmal bone cyst (ABC), giant cell tumour of bone (GCT), non ossifying fibroma, chondroblastoma, chondrosarcoma, and phosphaturic mesenchymal tumor. Desmoplastic fibroma must be differentiated from giant cell tumour of bone (GCT), non ossifying fibroma (NOF), fibrous dysplasia, low grade fibrosarcoma, unicameral bone cyst, chondromyxoid fibroma, periosteal desmoids, eosinophilic granuloma, low-grade intraosseous osteosarcoma, adamantinoma, and distant metastasis.[1][1][1] [1][1][1][1]

Differential Diagnosis

Type of Fibroma Differential Diagnosis
Ovarian fibroma
  • Large pedunculated subserosal uterine leiomyoma
  • Thecoma
  • Leiomyoma
  • Fibrosarcoma
  • Metastatic metaplastic carcinoma
  • Endometriosis with extensive fibrosis.
Non-ossifying fibroma
  • Fibrous cortical defect
  • Aneurysmal bone cyst
  • Chondromyxoid fibroma
  • Fibrous dysplasia
  • Desmoplastic fibroma
  • Giant cell tumour of bone
  • Spindle cell lesions of bone
Ossifying Fibroma
  • Fibrous dysplasia
  • Adamantinoma
  • Osteoid osteoma
Chondromyxoid Fibroma
  • Aneurysmal bone cyst (ABC)
  • Giant cell tumour of bone (GCT)
  • Non ossifying fibroma
  • Chondroblastoma
  • Chondrosarcoma
  • Phosphaturic mesenchymal tumor
Desmoplastic Fibroma
  • Giant cell tumour of bone (GCT)
  • Non ossifying fibroma (NOF)
  • Fibrous dysplasia
  • Low grade fibrosarcoma
  • Unicameral bone cyst
  • Chondromyxoid fibroma
  • Periosteal desmoids
  • Eosinophilic granuloma
  • Low-grade intraosseous osteosarcoma
  • Adamantinoma
  • Distant metastasis
Pleural Fibroma

Considerations for extremely well defined lesions include:

  • Pleural lipoma
  • Pleural fibrosarcoma
  • Intercostal nerve neurilemoma (schwannoma)

If not extremely well defined, broader considerations include:

  • Organised inflammation
  • Peripheral bronchogenic carcinoma
  • Solitary pleural metastasis

Also consider the differential for a single pleural mass which includes the following:

  • Pleural tumours
    • Solitary fibrous tumour of the pleura (pleural fibroma)
    • Mesothelioma
    • Localised mediastinal malignant mesothelioma
  • Metastatic pleural disease, particularly from adenocarcinomas
  • Pleural lymphoma
  • Invasive thymoma
  • Lipoma
  • Pleural effusion
  • Empyema
  • Haemothorax
  • Ewing sarcoma of chest wall, Askin tumour
  • Intercostal nerve neurilemmoma
  • Splenosis
  • Tuberculosis
Renal Medullary Fibroma
  • Renal myxoma
Cemento-ossifying Fibroma
  • Fibrous dysplasia
  • Ameloblastic fibro odontoma
  • Odontoma
  • Calcifying epithelial odontogenic tumour (Pindborg tumour)
  • Odontogenic cyst
  • Calcifying odontogenic cyst (Gorlin cyst)
  • Osteochondroma
  • Osteosarcoma
  • Chondrosarcoma
Desmoplastic fibroblastoma (Collagenous fibroma)
  • Fibromatosis
  • Elastofibroma
  • Low-grade fibromyxoid sarcoma.
Ameloblastic Fibroma
  • Ameloblastoma
Giant cell fibroma
  • Squamous Papilloma
  • Irritation fibroma
  • Pyogenic granuloma
  • Peripheral giant cell granuloma.
Oral Fibroma
  • Squamous Papilloma
  • Giant cell fibroma
  • Neurofibroma
  • Peripheral giant cell granuloma
  • Mucocele
  • Benign and malignant salivary gland tumors
Uterine Fibroma
  • Uterine leiomyosarcoma
  • Uterine smooth muscle tumours of uncertain malignant potential
  • Uterine lipoleiomyoma
  • Ovarian masses
  • Focal myometrial contraction (Braxton Hicks contraction): especially if seen during pregnancy
  • Focal adenomyosis
Peripheral odontogenic fibroma
  • Inflammatory gingival hyperplasia
  • Peripheral cemento-ossifying fibroma
  • Peripheral giant cell granuloma.
Peripheral odontogenic fibroma
  • Spindle cell lipoma
  • Nuchal-type fibroma
  • Fibromatosis colli

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Fibroma. Radiopedia(2015) http://radiopaedia.org/search?utf8=%E2%9C%93&q=fibroma&scope=all Accessed on March 12, 2016

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