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Kostakis ID, Feretis T, Damaskos C, Garmpis N, Liapis G, Pateras I, Garmpi A, Georgakopoulou VE, Antoniou EA. Nuchal-type Fibroma: Single-Center Experience and Systematic Literature Review. In Vivo 2021; 34:2217-2223. [PMID: 32871744 DOI: 10.21873/invivo.12032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Nuchal-type fibroma is a rare benign tumor arising from the connective tissue. Our aim was to present our experience via two cases of this tumor and a comprehensive review of the literature. PATIENTS AND METHODS We report a case of a 23-year-old female with a mass located in the posterior neck and the upper back and a case of a 50-year-old male with a mass located in the posterior neck, which were proved to be nuchal-type fibromas in the histopathological examination. We also searched the PubMed/Medline database for published cases of nuchal-type fibromas. RESULTS AND DISCUSSION Nuchal-type fibroma is a rare benign tumor arising from the connective tissue, usually in the posterior neck, which affects different ages, with most patients being male. It is a poorly circumscribed tumor consisting of hypocellular, thick, dense and haphazardly arranged collagen bundles with entrapped adipocytes, nerve fibers and muscle fascicles and a few scattered spindle cells, which are CD34 positive. Its excision is curative, and the recurrence risk is generally low. However, patients with Gardner's syndrome may experience recurrence more frequently. CONCLUSION Nuchal-type fibroma should be included in the differential diagnosis of subcutaneous, soft-tissue masses, especially when these involve the posterior neck.
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Affiliation(s)
- Ioannis D Kostakis
- Department of Transplantation, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - Themistoklis Feretis
- First Department of Endoscopic Surgery, Metropolitan General Hospital, Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece .,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Garmpis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Liapis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Pateras
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Efstathios A Antoniou
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Collagenosis Nuchae: a case report of a rare and often misdiagnosed condition. J Plast Reconstr Aesthet Surg 2006; 60:320-3. [PMID: 17293293 DOI: 10.1016/j.bjps.2006.03.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Accepted: 03/05/2006] [Indexed: 11/17/2022]
Abstract
Enzinger and Weiss first described Collagenosis Nuchae (CN) or nuchal fibroma (NF) in 1988. CN is a rare benign soft tissue tumour that arises from the posterior cervical subcutaneous tissue with predilection for the interscapular and paraspinal regions. It is more common in males. CN has been reported in association with trauma, diabetes, scleredema and Gardner's syndrome. The true incidence of CN is probably higher than recognised and CN should be in the differential diagnosis of head and neck lesions. Histological examination is required for the diagnosis. Careful total excision provides cure and accurate diagnosis. The purpose of this study is to review the epidemiological, clinical, histopathological and radiological features of this rare lesion, which is often misdiagnosed.
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Diwan AH, Horenstein MG. Dermatofibrosarcoma protuberans association with nuchal-type fibroma. J Cutan Pathol 2004; 31:62-6. [PMID: 14675287 DOI: 10.1046/j.0303-6987.2004.0129.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Dermatofibrosarcoma protuberans (DFSP) is a hypercellular, storiform, CD34-positive low-grade sarcoma with honeycomb entrapment of fat, which typically involves the trunk and extremities. Nuchal-type fibroma (NTF ) is a paucicellular, CD34-positive fibrous tumor with fat entrapment, which may occur in both nuchal and extranuchal locations and in association with Gardner syndrome. METHODS We report the association of DFSP with NTF in a 43-year-old male with no personal or family history of Gardner syndrome. RESULTS The patient had a past history of a DFSP removed from his back, which recurred 2 years later and was re-excised. Additionally, the patient had a typical NTF, in the posterior neck, removed at the same time. Histopathologic examination of the recurrent back lesion demonstrated a composite lesion with typical appearances of DFSP, centrally, blending into an NTF-like appearance, peripherally. Both components expressed CD34 and CD99, and lacked elastin. A review of the microscopic slides of the patient's previously excised DFSP revealed an identical lesion with surrounding NTF-like areas. CONCLUSION While an association between NTF and fibromatosis has recently been reported, this is to our knowledge the first report of an association between NTF and DFSP. The morphologic findings suggest that there may be a continuum between these two CD34-positive lesions that have a tendency to infiltrate adipose tissue and recur.
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Affiliation(s)
- A Hafeez Diwan
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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Samadi DS, McLaughlin RB, Loevner LA, LiVolsi VA, Goldberg AN. Nuchal fibroma: a clinicopathological review. Ann Otol Rhinol Laryngol 2000; 109:52-5. [PMID: 10651413 DOI: 10.1177/000348940010900110] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nuchal fibroma, or collagenosis nuchae, is a benign soft tissue tumor that arises from the posterior cervical subcutaneous tissue, with a predilection for the interscapular and paraspinal regions. Because of its benign clinical course and its close histopathologic similarity to other benign head and neck lesions, this lesion may be misdiagnosed and underreported. The purpose of this paper is to review the histopathologic and radiologic findings unique to nuchal fibroma, and compare and contrast it to the other soft tissue neoplasms within the clinical differential diagnosis. These include several benign (elastofibroma, lipoma, fibrolipoma, nodular fasciitis) and rare malignant entities (fibrosarcoma, liposarcoma, fibromatosis).
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Affiliation(s)
- D S Samadi
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia 19104, USA
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Abstract
Three cases of chronic infection with Borrelia burgdorferi are described. The patients presented with nodular or discoid fibrosis, partly in conjunction with acrodermatitis chronica atrophicans (ACA). Juxta-articular fibrotic nodules may develop within a few months of the onset of ACA. Nodular, discoid morphoea-like, and widespread cutaneous fibroses in chronic Borrelia infection may be provoked by trauma, surgery or electromagnetic radiation. They respond well to antibiotic therapy. These lesions offer an in vivo model for studying the evolution of immunologically induced fibrosis.
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Affiliation(s)
- W C Marsch
- Department of Dermatology, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany
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