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Nuchal-type fibroma†

A clinicopathologic study of 52 cases

  1. Michal Michal M.D.1,
  2. John F. Fetsch M.D.2,
  3. Ondrej Hes M.D.1,
  4. Markku Miettinen M.D.2,*

Article first published online: 19 NOV 2000

DOI: 10.1002/(SICI)1097-0142(19990101)85:1<156::AID-CNCR22>3.0.CO;2-O

Issue

Cancer

Cancer

Volume 85, Issue 1, pages 156–163, 1 January 1999

Additional Information

How to Cite

Michal, M., Fetsch, J. F., Hes, O. and Miettinen, M. (1999), Nuchal-type fibroma. Cancer, 85: 156–163. doi: 10.1002/(SICI)1097-0142(19990101)85:1<156::AID-CNCR22>3.0.CO;2-O

Author Information

  1. 1

    Soft Tissue Tumor Registry, Department of Pathology, Faculty Hospital, Pilsen, Czech Republic

  2. 2

    Department of Soft Tissue Pathology, Armed Forces Institute of Pathology, Washington, DC

*Armed Forces Institute of Pathology, Soft Tissue Department, 14th Street and Alaska Avenue, NW, Washington, DC 20306-6000.

  1. †

    The opinions and assertions contained herein are the expressed views of the authors and are not to be construed as official or reflecting the views of the Departments of the Army or Defense.

Publication History

  1. Issue published online: 19 NOV 2000
  2. Article first published online: 19 NOV 2000
  3. Manuscript Accepted: 9 JUL 1998
  4. Manuscript Revised: 26 JUN 1998
  5. Manuscript Received: 12 MAR 1998

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Keywords:

  • nuchal-type fibroma;
  • diabetes;
  • Gardner's syndrome;
  • fibromatosis;
  • diabetic scleredema

Fifty-two cases of nuchal-type fibroma, a tumorlike collagen accumulation that occurs mainly in the nuchal area, were analyzed. This study documents a significant association between this process and diabetes and also suggests a link with Gardner's syndrome.

Abstract

BACKGROUND

Nuchal-type fibroma (NTF) usually arises in the posterior aspect of the neck. Previously published reports describe only 11 cases and provide limited clinicopathologic information.

METHODS

Fifty-two examples of NTF from 50 patients were analyzed from the files of the Soft Tissue Registries of the Armed Forces Institute of Pathology in Washington, DC, and the Faculty Hospital in Pilsen, Czech Republic.

RESULTS

The age of the patients ranged from 3 to 74 years (mean, 40 years). There were 41 males and 9 females. Thirty-six NTFs were located in the posterior neck region and 16 were from extranuchal sites. Two patients had had lesions excised from both a nuchal and an extranuchal location. The mean greatest tumor dimension was 3.2 cm. Microscopically, all examples had a superficial (subcutaneous and sometimes dermal) component and consisted of paucicellular, thick bundles of lobulated collagen fibers with inconspicuous fibroblasts. Entrapped adipose tissue and traumatic neuromalike nerve proliferations were typically present. Skeletal muscle infiltration was also seen in a minority of cases. Eleven of 25 patients (44%) for whom clinical information was available reportedly had diabetes. Gardner's syndrome was documented in one patient and was possibly present in two additional individuals. During follow-up, five patients had local recurrences, but none of the recurrences were destructive and all were ultimately controlled by local reexcision.

CONCLUSIONS

NTF is a rare, tumorlike accumulation of collagen that often affects the posterior neck region but can also occur in a number of other sites. The process has a strong association with diabetes and also appears to be linked to Gardner's syndrome. Local recurrence probably reflects the persistence of local or systemic factors related to its pathogenesis. Cancer 1999;85:156–63. © 1999 American Cancer Society.

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