Fibroma

Fibroma is a benign neoplasm consisting of fibrous connective tissue, typically arising from fibroblasts. It can occur in many tissues throughout the body, most commonly in the skin, oral mucosa, or ovary. Fibromas are usually slow-growing, well-circumscribed lesions that may be asymptomatic, though they can become tender or cause cosmetic concerns depending on location.

Histologically, fibromas show a proliferation of spindle-shaped fibroblasts embedded in a dense collagenous stroma with relatively little cellular atypia and low mitotic activity. The lesion is often encapsulated or easily demarcated from surrounding tissue; the overlying epithelium may be normal or mildly hyperplastic in oral lesions. This contrasts with fibrosarcoma or desmoid-type fibromatosis, which are infiltrative and more aggressive.

Common forms include cutaneous fibromas, which present as firm, skin-colored nodules; oral irritation fibromas, reactive lesions at sites of chronic irritation or trauma; and ovarian fibroma, a solid tumor of the sex cord-stromal type that can present as an adnexal mass and, rarely, with Meigs syndrome (ascites and pleural effusion).

Diagnosis is established by histopathologic examination of biopsy or excised tissue; imaging may help assess extent in internal sites. Treatment is usually surgical excision. For most cutaneous and ovarian fibromas, complete removal is curative, and recurrence is uncommon. Malignant transformation is rare. The prognosis is generally excellent after appropriate management.