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Collagenous fibroma (desmoplastic fibroblastoma) of the neck presenting with neurological symptoms.

Fong F, Odell E, Simo R - Head Neck Pathol (2008)

Bottom Line: We describe a unique case of a 41-year-old woman presenting with a posterior neck swelling and longstanding history of severe ongoing pain in the right scapular region, shoulder and neck, weakness of the palmar grip and limited right lateral neck flexion and rotation.A history of trauma to the right neck in adolescence was noted.In a literature search on Medline and Pubmed, we found no reported cases of collagenous fibromas presenting with neurological symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Guy's and St. Thomas' NHS Foundation Trust, London, UK. farina@doctors.org.uk

ABSTRACT
Collagenous fibromas are rare fibrous soft tissue tumours that usually arise in subcutaneous tissue or skeletal muscle at a variety of anatomical sites. These lesions commonly present as painless, slow-growing mobile masses. We describe a unique case of a 41-year-old woman presenting with a posterior neck swelling and longstanding history of severe ongoing pain in the right scapular region, shoulder and neck, weakness of the palmar grip and limited right lateral neck flexion and rotation. A history of trauma to the right neck in adolescence was noted. Histological analysis revealed a paucicellular lesion with spindle and stellate-shaped fibroblasts involving the cervical nerve roots, typical of collagenous fibroma. In a literature search on Medline and Pubmed, we found no reported cases of collagenous fibromas presenting with neurological symptoms. This report highlights the potential of these lesions to present with neurological symptoms due to infiltration of surrounding tissues, and that preceding trauma may contribute to the aetiology.

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Clinical appearance of tumour
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Fig1: Clinical appearance of tumour

Mentions: A 41-year-old woman presented with a non-tender swelling in the right posterior neck, increasing in size over a period of 2 months. A history of previous significant trauma incurred during adolescence was noted, in which the patient had fallen from a horse and had been kicked in the right side of the neck. Further questioning revealed a 10-year history of severe ongoing pain over the right scapular region, shoulder and neck with no other sensory deficit. Neurological examination demonstrated weakness of palmar grip of the right hand, and limitation of right lateral rotation and flexion of the neck. She had previously been clinically diagnosed with unilateral cervical spondylosis but no radiological evidence was sought at the time. Examination of the neck revealed the presence of a 3 × 2 cm2 firm non-mobile mass located deep to the posterior border of the right sternocleidomastoid muscle at the level of C3/C4 (Fig. 1).Fig. 1


Collagenous fibroma (desmoplastic fibroblastoma) of the neck presenting with neurological symptoms.

Fong F, Odell E, Simo R - Head Neck Pathol (2008)

Clinical appearance of tumour
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2807529&req=5

Fig1: Clinical appearance of tumour
Mentions: A 41-year-old woman presented with a non-tender swelling in the right posterior neck, increasing in size over a period of 2 months. A history of previous significant trauma incurred during adolescence was noted, in which the patient had fallen from a horse and had been kicked in the right side of the neck. Further questioning revealed a 10-year history of severe ongoing pain over the right scapular region, shoulder and neck with no other sensory deficit. Neurological examination demonstrated weakness of palmar grip of the right hand, and limitation of right lateral rotation and flexion of the neck. She had previously been clinically diagnosed with unilateral cervical spondylosis but no radiological evidence was sought at the time. Examination of the neck revealed the presence of a 3 × 2 cm2 firm non-mobile mass located deep to the posterior border of the right sternocleidomastoid muscle at the level of C3/C4 (Fig. 1).Fig. 1

Bottom Line: We describe a unique case of a 41-year-old woman presenting with a posterior neck swelling and longstanding history of severe ongoing pain in the right scapular region, shoulder and neck, weakness of the palmar grip and limited right lateral neck flexion and rotation.A history of trauma to the right neck in adolescence was noted.In a literature search on Medline and Pubmed, we found no reported cases of collagenous fibromas presenting with neurological symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Guy's and St. Thomas' NHS Foundation Trust, London, UK. farina@doctors.org.uk

ABSTRACT
Collagenous fibromas are rare fibrous soft tissue tumours that usually arise in subcutaneous tissue or skeletal muscle at a variety of anatomical sites. These lesions commonly present as painless, slow-growing mobile masses. We describe a unique case of a 41-year-old woman presenting with a posterior neck swelling and longstanding history of severe ongoing pain in the right scapular region, shoulder and neck, weakness of the palmar grip and limited right lateral neck flexion and rotation. A history of trauma to the right neck in adolescence was noted. Histological analysis revealed a paucicellular lesion with spindle and stellate-shaped fibroblasts involving the cervical nerve roots, typical of collagenous fibroma. In a literature search on Medline and Pubmed, we found no reported cases of collagenous fibromas presenting with neurological symptoms. This report highlights the potential of these lesions to present with neurological symptoms due to infiltration of surrounding tissues, and that preceding trauma may contribute to the aetiology.

Show MeSH
Related in: MedlinePlus