Fibroma

Overview

Fibroma is a benign (noncancerous) tumor, composed of fibrous and connective tissues. Most of the fibromas do not cause any symptoms, and might not even be noticed during development. Being non-cancerous, they generally do not require any treatment unless they start manifesting symptoms or affecting your life.

Fibroma cysts can be formed anywhere, all over your body, with the female reproductive system being one of the common areas for fibroma development. However, these fibroma cysts are slow-growing and may appear as nodules or lumps.

Types of Fibromas

Fibromas can be divided into different types based on their specific locations and characteristics. Here are some common types of fibromas: 

Oral Fibroma

Oral Fibroma (irritational fibroma) is found in the mouth, especially on the gums or inner cheek lining. They are often associated with irritation or trauma, such as biting the cheek.

Uterine Fibroid

This type of fibroma develops in the uterus and is also the most common type of benign tumor in women of childbearing age. Fibroma uterine can cause symptoms like heavy menstrual bleeding, pelvic pain, or pressure.

Plantar Fibroma

This type of fibroma develops in the foot, specifically on the plantar fascia. Your plantar fascia is a thick band of tissues on the sole that supports your muscles. Plantar fibromas can cause discomfort and difficulty with walking.

Non-ossifying Fibroma 

A non-ossifying fibroma is a harmless bone tumor that is composed of scar tissue. Non-ossifying fibroma grows on your bone, but it’s not made of bone. This type of fibroma can be seen affecting children and teenagers.  

Angiofibroma 

An Angiofibroma is a type of benign tumor, made up of fibrous tissue and blood vessels. These benign tumors typically occur in the skin or soft tissues of the head and neck region – particularly around the nose (nasal cavity) and upper lip. Besides that, they look like small, flesh-colored, pink, or red pimples on your cheeks or nose. 

Dermatofibroma 

A Dermatofibroma is a common harmless bump that appears on the skin, usually on the legs. It feels firm and raised, often with a slightly dimpled center. These bumps can be small, about the size of a pea, and may have a reddish-brown or skin-colored look. 

Describe Tumors?

Tumors, also known as neoplasms, are abnormal growths of cells that can occur in any part of the body. They result from uncontrolled and excessive cell division. Tumors can be classified based on their nature (benign or malignant), their tissue of origin, and their biological behavior. Here are the key points about tumors:

Classification of Tumors

1. Benign Tumors

• Non-Cancerous: These tumors do not invade surrounding tissues or spread to other parts of the body.
• Slow Growth: They typically grow slowly.
• Encapsulation: Often encapsulated, meaning they are confined within a clear boundary.
• Examples: Lipomas (fat tissue), fibromas (fibrous tissue), adenomas (glandular tissue), and meningiomas (meninges of the brain).

2. Malignant Tumors (Cancer)

• Cancerous: These tumors invade nearby tissues and can metastasize (spread) to distant parts of the body through the bloodstream or lymphatic system.
• Rapid Growth: They tend to grow quickly and uncontrollably.
• Invasive and Destructive: They infiltrate and destroy surrounding tissues.
• Examples: Carcinomas (epithelial tissue), sarcomas (connective tissue), leukemias (blood-forming tissues), and lymphomas (lymphatic tissue).

Types of Tumors by Tissue Origin

1. Epithelial Tumors

• Carcinomas: Malignant tumors arising from epithelial cells. Examples include squamous cell carcinoma, adenocarcinoma, and basal cell carcinoma.
• Adenomas: Benign tumors arising from glandular epithelium.

2. Connective Tissue Tumors

• Sarcomas: Malignant tumors arising from connective tissues like bone (osteosarcoma), cartilage (chondrosarcoma), fat (liposarcoma), and muscle (leiomyosarcoma).
• Fibromas: Benign tumors of fibrous tissue.

3. Nervous Tissue Tumors

• Gliomas: Tumors arising from glial cells in the brain or spine.
• Neuroblastomas: Malignant tumors arising from immature nerve cells.

4. Blood and Lymphatic Tissue Tumors

• Leukemias: Malignancies of blood-forming tissues, leading to excessive production of abnormal white blood cells.
• Lymphomas: Malignant tumors of the lymphatic system, such as Hodgkin’s lymphoma and non-Hodgkin’s lymphoma.
  

Fibroma vs Fibroid

Both fibroma and fibroid are non-cancerous growths made up of fibrous tissues, but they develop in different parts of the body. A fibroma can appear on the skin, mouth, or soft tissues as small lumps, while a fibroid specifically refers to a benign tumor, formed in the muscular wall of the uterus (uterine fibroid). 

Uterine fibroids can vary in size and number, often causing symptoms like heavy periods, pelvic pain, or pressure. Treatment approaches for fibroma and fibroid depend on their location and the associated symptoms, tailored to each person’s needs.

What is Gaint Cell Fibroma?

Giant cell fibroma (GCF) is a harmless, non-cancerous bump that typically appears in the mouth. It consists of large cells with multiple nuclei within a fibrous tissue. GCF usually presents as a small, firm bump that can be smooth or bumpy, and is typically pink or slightly red. The size of GCF is generally less than 1 cm. It most often occurs on the gums, particularly in the lower jaw, but it can also be found on the tongue, the roof of the mouth, and other areas within the oral cavity. GCF is more common in younger individuals, usually under the age of 30, and is slightly more prevalent in females.

What is Soft Fibroma?

Soft fibroma, also known as a skin tag or acrochordon, is a harmless growth on the skin. It looks like a small piece of soft skin that can stick out and often has a thin stalk attaching it to the rest of the skin. These growths are usually flesh-colored or slightly darker and are most commonly found in places where skin rubs against skin or clothing, like the neck, armpits, groin, and eyelids.

Soft fibromas are generally small, ranging from a few millimeters to over a centimeter in size. They feel soft to the touch and may have a smooth or slightly wrinkled texture. The color of a soft fibroma often blends with the surrounding skin or might be a bit darker.

They are quite common, especially among older adults. Most of the time, soft fibromas don’t cause any problems and don’t have any symptoms. However, they can sometimes get irritated or uncomfortable if they snag on clothing or jewelry.

What is Cemento ossifying fibroma?

 Cemento-ossifying fibroma (COF) is a benign tumor that typically arises in the jawbones, particularly the mandible or maxilla. It involves the formation of bone (ossification) and cementum-like tissue. COF appears as a well-defined lesion on imaging, often discovered incidentally or due to swelling and discomfort. Treatment usually involves surgical removal, and while recurrence is rare, periodic monitoring is recommended.

Causes

Several causes can lead to Fibroma, such as certain genetic conditions or mutations that can increase the risk of developing fibroma.

Hormonal changes or imbalances can play a major role in developing certain fibromas, particularly uterine fibroids. Estrogen has been implicated in the growth and maintenance of uterine fibroids. 

Fibromas can sometimes develop in response to tissue injury or trauma. For example, Dermatofibromas are believed to arise from minor skin injuries, such as insect bites or thorn pricks.

Prolonged irritation or inflammation of tissues can also contribute to the formation of fibromas. For instance, oral fibromas (traumatic fibroma) can arise in response to chronic irritation from dental appliances, tobacco use, or repeated biting of the cheek.

Symptoms

Fibroma symptoms vary depending on the type of fibroma. Some fibromas do not cause any symptoms, but the ones that do, include: 

Oral Fibroma

• Firm, smooth, raised lesions in the mouth, often on the gums, inner cheek, or tongue.
• Appear whitish, pinkish, or similar to the surrounding tissue.

Uterine Fibroids

• Heavy menstrual bleeding (menorrhagia), leads to prolonged or excessive periods.
• Pelvic pain or pressure, which can be constant or intermittent.
• Frequent urination or difficulty emptying the bladder due to pressure on the bladder.
• Pain during intercourse (dyspareunia) if the fibroid affects the cervix or vaginal wall.
• Lower back pain or leg pain if the fibroid presses on nerves or blood vessels.

Plantar Fibroma

• Pain or tenderness in the sole, particularly when walking or standing.
• Palpable lump or thickening in the plantar fascia (connective tissue on the bottom of the foot).
• Difficulty wearing certain shoes or discomfort with weight-bearing activities.

Non-Ossifying Fibroma

• Rarely, non-ossifying fibromas can cause pain if they weaken the bone structure or lead to a pathologic fracture (fracture due to bone weakness).
• Present with localized tenderness over the affected bone if symptomatic.

Angiofibroma

• Reddish or skin-colored papules or nodules on the skin, particularly around the nose (nasal area) or upper lip.
• Lesions may bleed easily, especially with minor trauma or manipulation.

Dermatofibroma

• Small, firm, raised nodules on the skin, often on the lower legs, and appear elsewhere.
• Have a dimpled or depressed center when viewed from the side (known as the dimple sign).

Diagnosis

Your physician will start by examining the area where you have growth, to check for signs of a fibroma. The physicians will then inquire about any symptoms you’ve noticed, along with your medical history.

Depending on the type of growth and where it’s located, your healthcare provider may order tests to confirm the fibroma diagnosis. These tests may include: 

• Ultrasound
• Blood test
• X-ray
• Bone scan
• CT (Computed Tomography) scan
• MRI (Magnetic Resonance Imaging) scan

If needed, your physician may also perform a biopsy. During the biopsy, a small sample of tissues will be taken from the growth in order to be examined closely under a microscope, confirming the diagnosis of a fibroma.

What are the Diagnosis of Gaint Cells Fibroma?

Diagnosing a Giant Cell Fibroma (GCF) involves a combination of clinical examination and histological analysis. Here are the steps typically involved in the diagnosis:

 Clinical Examination

Visual Inspection: A healthcare provider will examine the lesion’s appearance, noting its size, shape, color, and location. GCFs usually present as small, firm, pink or slightly red nodules that can be smooth or lobulated.

Palpation: The lesion is palpated to assess its firmness and mobility.

Patient History: A detailed history is taken to understand the duration of the lesion and any associated symptoms or potential causes of irritation.

Differential Diagnosis

GCF must be distinguished from other similar-appearing oral lesions, such as:

 Irritation Fibroma: A common fibrous hyperplasia without the characteristic giant cells.

Peripheral Giant Cell Granuloma: Contains numerous multinucleated giant cells and is typically more vascular.

Peripheral Ossifying Fibroma: May contain calcifications and bone formation.

Other Benign and Malignant Lesions: Such as papillomas, lipomas, and various types of carcinomas.

Histological Examination

Biopsy: A small tissue sample from the lesion is taken for microscopic examination. This is a crucial step for a definitive diagnosis.

Microscopic Analysis: The biopsy sample is analyzed to look for the characteristic features of GCF:

Giant Cells: Presence of large, stellate (star-shaped) or multinucleated fibroblasts.

Fibrous Stroma: A dense fibrous connective tissue background.

Epithelial Changes: The overlying epithelium may show thickening (acanthosis) and elongated rete ridges.

Treatment

Fibromas usually don’t go away on their own, but if they’re not causing any problems or symptoms, your physician may recommend letting them be, without treatment. However, if a fibroma is causing trouble in your daily life, you might need to consider getting it treatment. The type of treatment depends on the specific fibroma.

For plantar fibromas treatment, physicians may suggest using shoe inserts (orthotics), doing stretching exercises, or receiving corticosteroid injections as non-invasive treatments. Surgery is rarely needed for this type of fibroma.

Non-ossifying fibromas typically don’t require treatment. Physicians may simply monitor the tumor in children. If the fibroma grows too large and poses a risk of weakening the bone structure, physicians may recommend surgical removal.

If angiofibroma causes pain or if you want it removed for cosmetic reasons, physicians may suggest cryotherapy, laser treatment, or dermabrasion.

Dermatofibromas can be surgically removed by physicians, but keep in mind that tissue changes and scars from the procedure can alter your appearance. Surgical removal is usually a straightforward outpatient procedure. Cryotherapy is another method that can be used to remove dermatofibromas.

For oral fibromas, surgical removal is usually necessary. However, these growths may come back – so it’s important to address the source of irritation to help prevent recurrence.

Noninvasive treatments for uterine fibroids include medications or a procedure called uterine artery embolization. If uterine fibroids affect fertility or cause severe symptoms, surgery such as myomectomy may be needed. There are various other treatment options for uterine fibroids, that can be opted depending on each individual’s circumstances and symptoms.

When To See A Doctor

If you notice sudden changes in a fibroma like rapid growth, color change, or pain – visit your healthcare provider right away. Seek primary care physicians for discomfort or symptoms such as heavy periods, pelvic pain, or frequent urination.

Oral fibromas that bleed or do not heal on their own should be checked by a dentist. Any concerns regarding cancer, due to the rapid growth of fibroma, should be evaluated by a doctor. If fibroids affect your quality of life, you need to have it discussed with a healthcare provider.

Summary

Fibromas are benign tumors composed of fibrous and connective tissues, often unnoticed as they typically do not cause symptoms. They can develop in various body parts, with the female reproductive system being a common site. It is estimated that up to 70-80% of women will develop uterine fibroids by age 50. Types of fibromas include oral fibromas, uterine fibroids, plantar fibromas, non-ossifying fibromas, angiofibromas, and dermatofibromas.

Tumors, or neoplasms, are abnormal cell growths classified as benign (non-cancerous) or malignant (cancerous). While benign tumors grow slowly and do not invade surrounding tissues, malignant tumors can spread and destroy nearby tissues. Approximately 90% of tumors are benign, highlighting the relatively low risk of cancer associated with fibromas.

Giant cell fibromas (GCF) are non-cancerous bumps in the mouth that typically appear as small, firm pink or red nodules, occurring more frequently in young adults. Soft fibromas, also known as skin tags, are harmless growths resembling small pieces of soft skin, often found in areas where skin rubs against skin or clothing. They affect up to 25% of the adult population, with incidence increasing with age. Cemento-ossifying fibromas (COF) arise in the jawbones and involve bone formation.

Factors contributing to fibroma development include genetic predisposition, hormonal changes (particularly in uterine fibroids), and tissue injury or irritation. Studies indicate that African American women are at higher risk for developing fibroids, with higher rates of severity compared to women of other ethnicities. Symptoms can vary but may include raised lesions, heavy menstrual bleeding, pelvic pain, or localized tenderness. Up to 30% of women with uterine fibroids experience significant symptoms requiring treatment.

Diagnosis involves a physical examination and may include imaging tests or biopsies. Treatment is typically considered only if symptoms arise. Options may include shoe inserts, corticosteroid injections, cryotherapy, laser treatment, or surgical removal, depending on the type and location of the fibroma. In cases of uterine fibroids, around 25% of women may require surgical intervention, often through procedures like myomectomy or hysterectomy, depending on their specific situation.

Disclaimer

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about Fibroma or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.