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Collagenous fibroma (desmoplastic fibroblastoma)

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Summary

Collagenous fibroma (desmoplastic fibroblastoma) is a rare, benign subcutaneous soft tissue tumor that affects mostly men in their 50s to 70s, predominantly on the upper and lower extremities.

Men are affected by this tumor 4 times more frequently than women. The age range is wide, withe the peak age at diagnosis being in the 50s, 60s, and 70s.
Patient presents with a slowly growing painless mass in the subcuticular tissues a peripheral site, most commonly the upper or lower extremities, which may involve skeletal muscle. The size may be from one to several centimeters, with masses as large as 20 cm possible.
X-ray findings are normal.
Complete surgical removal is curative.
Complete Information on this Tumor
Introduction and Definition: 

Collagenous fibroma (desmoplastic fibroblastoma) is a rare, benign subcutaneous soft tissue tumor that affects mostly men in their 50s to 70s, predominantly on the upper and lower extremities.

Incidence and Demographics: 
Men are affected by this tumor 4 times more frequently than women. The age range is wide, withe the peak age at diagnosis being in the 50s, 60s, and 70s.
Symptoms and Presentation: 

Patient presents with a slowly growing painless mass in the subcuticular tissues a peripheral site, most commonly the upper or lower extremities, which may involve skeletal muscle. The size may be from one to several centimeters, with masses as large as 20 cm possible.

X-Ray Appearance and Advanced Imaging Findings: 
X-ray findings are normal. show no calcification or bone erosion. No distinguishing features are present on plain x-rays other than the lack of bone erosion or soft tissue calcification. The MRI scan shows a lobular mass with heterogeneous intermediate signal intensity on T1 and T2 sequences.
Differential Diagnosis: 
Lipoma, synovial sarcoma, epithelioid sarcoma, neurofibroma.
Histopathology findings: 
The tumor consists of bland stellate and spindled fibroblasts in a collagenous or collagen-myxoid matrix. There is usually little or no mitotic activity.
Treatment Options for this Tumor: 
Excision with a marginal margin is curative. Recurrence is not expected following complete excision.