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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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Related in: MedlinePlus

T2-weighted MRI scan of neck (coronal view). The tumour (arrow) is shown in the right cervical space as an area of low signal intensity with a surrounding region of peripheral enhancement
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Fig2: T2-weighted MRI scan of neck (coronal view). The tumour (arrow) is shown in the right cervical space as an area of low signal intensity with a surrounding region of peripheral enhancement

Mentions: Ultrasound scanning showed a hyperechoic mass within the pre-vertebral muscles of the posterior triangle of the neck and fine needle aspiration failed to yield sufficient aspirate for cytopathological analysis. A computerised tomography scan revealed a soft tissue mass arising laterally to the origin of the deltoid muscle, suggestive of a soft tissue sarcoma. Magnetic resonance imaging (MRI) of the neck showed a 3 × 2 × 1 cm3 lesion of intermediate T1 and low T2 signal intensity within the right posterior cervical space, that could not be separated from the adjacent scalene and levator scapulae muscles. There was no evidence of cervical spondylosis. A peripheral area of enhancement surrounded the lesion, suggesting a neoplastic or inflammatory process (Fig. 2). An incisional biopsy was recommended by the multidisciplinary head and neck oncology team and the histological analysis confirmed the diagnosis of collagenous fibroma.Fig. 2


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

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

T2-weighted MRI scan of neck (coronal view). The tumour (arrow) is shown in the right cervical space as an area of low signal intensity with a surrounding region of peripheral enhancement
© Copyright Policy
Related In: Results  -  Collection

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

Fig2: T2-weighted MRI scan of neck (coronal view). The tumour (arrow) is shown in the right cervical space as an area of low signal intensity with a surrounding region of peripheral enhancement
Mentions: Ultrasound scanning showed a hyperechoic mass within the pre-vertebral muscles of the posterior triangle of the neck and fine needle aspiration failed to yield sufficient aspirate for cytopathological analysis. A computerised tomography scan revealed a soft tissue mass arising laterally to the origin of the deltoid muscle, suggestive of a soft tissue sarcoma. Magnetic resonance imaging (MRI) of the neck showed a 3 × 2 × 1 cm3 lesion of intermediate T1 and low T2 signal intensity within the right posterior cervical space, that could not be separated from the adjacent scalene and levator scapulae muscles. There was no evidence of cervical spondylosis. A peripheral area of enhancement surrounded the lesion, suggesting a neoplastic or inflammatory process (Fig. 2). An incisional biopsy was recommended by the multidisciplinary head and neck oncology team and the histological analysis confirmed the diagnosis of collagenous fibroma.Fig. 2

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