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Difference between revisions of "Oral fibroma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Oral fibroma -- very low mag.jpg | |||
| Width = | |||
| Caption = Oral fibroma. [[H&E stain]]. | |||
| Synonyms = fibroma, focal fibrous hyperplasia, peripheral fibroma, peripheral ossifying fibroma, fibroid epulis (old term), [[fibroepithelial polyp]] | |||
| Micro = fibrous stroma +/-collagen bundles, prominent (dilated) vessels, overlying (squamous) mucosa benign +/-hyperkeratosis +/-focal ulceration | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = polypoid lesion, usually small | |||
| Grossing = | |||
| Staging = | |||
| Site = oral cavity - see ''[[oral pathology]]'' and ''[[head and neck pathology]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = very common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = [[squamous papilloma]], other polypoid lesions | |||
| Tx = removal | |||
}} | |||
'''Oral fibroma''', typically referred to as simply '''[[fibroma]]''', is a very common benign lesion in [[oral pathology]]. | |||
It is also known as '''focal fibrous hyperplasia''', '''peripheral fibroma''', '''peripheral ossifying fibroma''', '''fibroid epulis''' (old term), and '''[[fibroepithelial polyp]]'''.<ref name=Ref_Sternberg5_775>{{Ref Sternberg5|775}}</ref><ref>URL: [http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3 http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3]. Accessed on: 20 August 2012.</ref><ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | |||
==General== | |||
*Most common oral cavity tumour.<ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | |||
*Female predominance (female:male = 2:1), usually 30-50 years old.<ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | |||
*Multiple oral fibromas may be seen in [[Cowden disease]].<ref name=pmid16878060>{{Cite journal | last1 = Segura Saint-Gerons | first1 = R. | last2 = Ceballos Salobreña | first2 = A. | last3 = Toro Rojas | first3 = M. | last4 = Gándara Rey | first4 = JM. | title = Oral manifestations of Cowden's disease. Presentation of a clinical case. | journal = Med Oral Patol Oral Cir Bucal | volume = 11 | issue = 5 | pages = E421-4 | month = Aug | year = 2006 | doi = | PMID = 16878060 }}</ref><ref name=pmid20137749>{{Cite journal | last1 = Oliveira | first1 = MA. | last2 = Medina | first2 = JB. | last3 = Xavier | first3 = FC. | last4 = Magalhães | first4 = M. | last5 = Ortega | first5 = KL. | title = Cowden syndrome. | journal = Dermatol Online J | volume = 16 | issue = 1 | pages = 7 | month = | year = 2010 | doi = | PMID = 20137749 | URL = http://dermatology.cdlib.org/1601/case_reports/cowden/ortega.html }}</ref> | |||
*Histologically similar to [[fibrous papule]].<ref name=pmid20421776>{{Cite journal | last1 = Fernandez-Flores | first1 = A. | title = Solitary oral fibromas of the tongue show similar morphologic features to fibrous papule of the face: a study of 31 cases. | journal = Am J Dermatopathol | volume = 32 | issue = 5 | pages = 442-7 | month = Jul | year = 2010 | doi = 10.1097/DAD.0b013e3181c47142 | PMID = 20421776 }}</ref> | |||
Clinical DDx: | |||
*[[Squamous papilloma]]. | |||
==Microscopic== | |||
Features:<ref name=pmid20421776/> | |||
*Fibrous stroma - '''key feature'''. | |||
**"Very pink" at low power. | |||
*+/-Collagen bundles, may be prominent. | |||
*Prominent (dilated) vessels. | |||
*Overlying (squamous) mucosa benign (flat). | |||
**+/-Hyperkeratosis +/-focal ulceration.<ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | |||
===Images=== | |||
<gallery> | |||
Image: Oral fibroma -- very low mag.jpg | OF - very low mag. (WC) | |||
Image: Oral fibroma -- low mag.jpg | OF - low mag. (WC) | |||
Image: Oral fibroma -- intermed mag.jpg | OF - intermed. mag. (WC) | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
Lower Buccal Lesion, Left, Excision: | |||
- Fibroma. | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
<pre> | |||
Left Tongue Lesion, Excision: | |||
- Fibroma with overlying squamous epithelium with parakeratosis. | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
====Block letters==== | |||
<pre> | |||
TONGUE LESION, BIOPSY: | |||
- FIBROMA. | |||
</pre> | |||
===Micro=== | |||
The sections show a polypoid fragment of squamous mucosa with a thin layer of parakeratosis. The subepithelial tissue consists of abundant fibrous tissue and has dilated small blood vessels. | |||
No significant inflammation is present. No nuclear atypia is apparent. No necrosis is present. No proliferative activity is apparent. | |||
==See also== | |||
*[[Oral pathology]]. | |||
*[[Fibroma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Oral pathology]] | |||
[[Category:Head and neck pathology]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||