Fibroma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2], Simrat Sarai, M.D. [3]


Oral fibroma must be differentiated from squamous papilloma, giant cell fibroma, neurofibroma, peripheral giant cell granuloma, mucocele, and benign and malignant salivary gland tumors. Non-ossifying fibroma must be differentiated from fibrous cortical defect, aneurysmal bone cyst, chondromyxoid fibroma, fibrous dysplasia, desmoplastic fibroma, giant cell tumor of bone, and spindle cell lesions of bone. Ossifying fibroma must be differentiated from ossifying fibroma, fibrous dysplasia, adamantinoma, and osteoid osteoma. Chondromyxoid fibroma must be differentiated from aneurysmal bone cyst (ABC), giant cell tumor of bone (GCT), non-ossifying fibroma, chondroblastoma, chondrosarcoma, and phosphaturic mesenchymal tumor. Desmoplastic fibroma must be differentiated from giant cell tumor of bone (GCT), non- ossifying fibroma (NOF), fibrous dysplasia, low grade fibrosarcoma, unicameral bone cyst, chondromyxoid fibroma, periosteal desmoids, eosinophilic granuloma, low-grade intraosseous osteosarcoma, adamantinoma, and distant metastasis.

Differential Diagnosis

Type of Fibroma Differential Diagnosis
Ovarian fibroma
  • Large pedunculated subserosal uterine leiomyoma
  • Thecoma
  • Leiomyoma
  • Fibrosarcoma
  • Metastatic metaplastic carcinoma
  • Endometriosis with extensive fibrosis.
Non-ossifying fibroma
Ossifying Fibroma
Chondromyxoid Fibroma
Desmoplastic Fibroma
Pleural Fibroma

Considerations for extremely well defined lesions include:

If not extremely well defined, broader considerations include:

  • Organised inflammation
  • Peripheral bronchogenic carcinoma
  • Solitary pleural metastasis

Also consider the differential for a single pleural mass which includes the following:

Renal Medullary Fibroma
  • Renal myxoma
Cemento-ossifying Fibroma
Desmoplastic fibroblastoma (Collagenous fibroma)
Ameloblastic Fibroma
  • Ameloblastoma
Giant cell fibroma
Oral Fibroma
Uterine Fibroma
  • Uterine leiomyosarcoma
  • Uterine smooth muscle tumors of uncertain malignant potential
  • Uterine lipoleiomyoma
  • Ovarian masses
  • Focal myometrial contraction (Braxton Hicks contraction): especially if seen during pregnancy
  • Focal adenomyosis
Peripheral odontogenic fibroma
  • Spindle cell lipoma
  • Nuchal-type fibroma
  • Fibromatosis colli


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