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Successful management of aggressive fibromatosis of the neck using wide surgical excision: a case report.

Sobani ZA, Junaid M, Khan MJ - J Med Case Rep (2011)

Bottom Line: Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck.However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity.We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical College, Aga Khan University, Stadium Road, Karachi, Pakistan. zsobani@gmail.com.

ABSTRACT

Introduction: Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck. However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity.

Case presentation: We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck. The mass was excised and histopathological analysis revealed a case of aggressive fibromatosis.

Conclusion: Due to the rarity of the condition no guidelines are available on the indications and extent of each modality. Due to its aggressive behavior and tendency to invade local structures and recur, a multi-modality management strategy is usually employed. On the basis of this case, we suggest that aggressive surgery is a viable management option and may be successfully used as a single modality treatment.

No MeSH data available.


Related in: MedlinePlus

Histopathological examination of the excised tissue. (A) Fibrosarcoma arising in a background of dermatofibrosarcoma protuberans showing proliferation of spindle cells with a prominent storiform pattern and cells exhibiting pleomorphism with increase mitotic activity (H&E, 10 ×). (B) Fibromatosis showing proliferation of bland spindle shaped cells with infiltration into the muscle at the periphery and perivascular lymphocytic infiltrate (H&E, 10 ×).
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Figure 4: Histopathological examination of the excised tissue. (A) Fibrosarcoma arising in a background of dermatofibrosarcoma protuberans showing proliferation of spindle cells with a prominent storiform pattern and cells exhibiting pleomorphism with increase mitotic activity (H&E, 10 ×). (B) Fibromatosis showing proliferation of bland spindle shaped cells with infiltration into the muscle at the periphery and perivascular lymphocytic infiltrate (H&E, 10 ×).

Mentions: The mass was resected and an extended right neck dissection was performed. Analysis of the excised tissue revealed spindle cells arranged in whorls and fascicles, with intervening thin walled vessels and extravasation of red blood cells. There was no evidence of atypical mitosis or necrosis; however, focal infiltration of adjacent muscle was noted, favoring benign fibromatosis [Figure 4].


Successful management of aggressive fibromatosis of the neck using wide surgical excision: a case report.

Sobani ZA, Junaid M, Khan MJ - J Med Case Rep (2011)

Histopathological examination of the excised tissue. (A) Fibrosarcoma arising in a background of dermatofibrosarcoma protuberans showing proliferation of spindle cells with a prominent storiform pattern and cells exhibiting pleomorphism with increase mitotic activity (H&E, 10 ×). (B) Fibromatosis showing proliferation of bland spindle shaped cells with infiltration into the muscle at the periphery and perivascular lymphocytic infiltrate (H&E, 10 ×).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3141701&req=5

Figure 4: Histopathological examination of the excised tissue. (A) Fibrosarcoma arising in a background of dermatofibrosarcoma protuberans showing proliferation of spindle cells with a prominent storiform pattern and cells exhibiting pleomorphism with increase mitotic activity (H&E, 10 ×). (B) Fibromatosis showing proliferation of bland spindle shaped cells with infiltration into the muscle at the periphery and perivascular lymphocytic infiltrate (H&E, 10 ×).
Mentions: The mass was resected and an extended right neck dissection was performed. Analysis of the excised tissue revealed spindle cells arranged in whorls and fascicles, with intervening thin walled vessels and extravasation of red blood cells. There was no evidence of atypical mitosis or necrosis; however, focal infiltration of adjacent muscle was noted, favoring benign fibromatosis [Figure 4].

Bottom Line: Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck.However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity.We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical College, Aga Khan University, Stadium Road, Karachi, Pakistan. zsobani@gmail.com.

ABSTRACT

Introduction: Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck. However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity.

Case presentation: We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck. The mass was excised and histopathological analysis revealed a case of aggressive fibromatosis.

Conclusion: Due to the rarity of the condition no guidelines are available on the indications and extent of each modality. Due to its aggressive behavior and tendency to invade local structures and recur, a multi-modality management strategy is usually employed. On the basis of this case, we suggest that aggressive surgery is a viable management option and may be successfully used as a single modality treatment.

No MeSH data available.


Related in: MedlinePlus