Fibroma

Disease Description (Causes and Symptoms)

• Definition: A fibroma is a benign tumor composed of connective tissue, including fibroblasts and collagen. It can occur in various areas, including the skin, mucous membranes, and bone. Subtypes include fibrolipoma (a mixture of fibrous tissue and fat), soft fibroma (skin tag), irritation fibroma (in the oral cavity), and ossifying fibroma (a form accompanied by involvement of bone tissue).
• Causes/Pathophysiology: Although the exact mechanism is unknown, local trauma, chronic irritation, and genetic predisposition may be involved. The basic mechanism is the proliferation of fibroblasts and excessive formation of connective tissue. Ossifying fibroma shows calcification or ossification within the lesion and may destroy or deform the surrounding bone tissue.
• Main symptoms: Most are asymptomatic and appear as single or multiple firm or soft lumps (nodules). As they grow, cosmetic problems, pain or functional impairment due to pressure, and surface ulceration or bleeding may occur. In forms involving bone, symptoms such as facial deformity, pain, and an increased tendency for fractures may occur.

Treatment Methods

• Diagnostic principles: A definitive diagnosis is made through clinical findings, imaging (X-ray, CT, or MRI if necessary), and pathological examination of tissue. When bone involvement, such as ossifying fibroma, is suspected, calcified shadows may be observed on radiographs.
• Conservative management: Small benign lesions that are asymptomatic and do not cause cosmetic or functional problems can be sufficiently managed with observation, including regular monitoring of their size.
• Local treatment/Surgery: Surgical excision is performed when symptoms are present, for cosmetic reasons, because of functional impairment, or for differential diagnosis (to rule out a malignant tumor). After excision, pathological examination is performed to confirm the diagnosis and determine whether malignant transformation has occurred.
  • Skin or mucosal lesions: Local excision, electrocautery, or cryotherapy may be possible, depending on the lesion.
  • Oral irritation fibroma: Excision of the lesion and removal of the source of irritation, such as a tooth projection or prosthesis.
  • Ossifying fibroma (bone-involving form): To prevent recurrence, extensive resection of the surrounding bone tissue including the lesion and, if necessary, reconstructive surgery may be considered.
• Medication: There is no specific drug treatment, and anticancer drugs are not necessary (separate treatment may be required if malignancy is identified).
• Follow-up management: Regular follow-up, including clinical and imaging examinations, is recommended after excision according to the pathology results and whether recurrence occurs.
• Lifestyle management/Precautions: Avoid repeated trauma and chronic irritation. For oral lesions, check the condition of prostheses and orthodontic appliances and maintain good oral hygiene.

Checklist Before an Outpatient Visit (Preparation and Example Questions)

• Things to prepare
  • A list of current medications, including anticoagulants and antiplatelet drugs
  • Past medical history and surgical history, particularly any history related to tumors, and family history
  • Records of when the lesion developed, its growth rate (when it began to enlarge), and whether pain, bleeding, or ulceration is present
  • Previous test results, such as imaging or pathology reports, or photographs (useful for comparing changes from the initial stage to the present, if available)
  • Lifestyle habits, including whether repeated friction or trauma occurs because of work
• Examinations that may be performed during the outpatient visit
  • Clinical examination, including assessment of size, firmness, and attachment
  • Skin or mucosal biopsy if necessary (pathological examination)
  • X-ray/CT/MRI if bone involvement is suspected
  • General evaluation, including blood tests, if surgery is planned

Examples of General Questions to Ask the Doctor

• "Is this lesion definitely benign? Do I need any additional tests?"
• "Which treatment option—observation or excision—is appropriate? If I have surgery, what is the possibility of scarring or complications?"
• "How likely is the lesion to recur after excision?"
• "What activities should I avoid in daily life, and how should I manage the condition?"
• "Are there any medications I need to stop taking before or after surgery?"

Examples of Condition-Specific Questions

• If bone involvement (ossifying fibroma) is suspected: "To what extent has the lesion invaded the bone? Is extensive resection necessary? Will reconstruction, such as a bone graft or implant, be needed?"
• If it is an oral irritation fibroma: "What is considered to be the source of irritation in the oral cavity, such as a tooth, prosthesis, or habit? Can removing the source of irritation reduce the risk of recurrence?"

Additional guidance: Early medical evaluation is recommended if the lesion grows rapidly or is accompanied by pain, bleeding, neurological symptoms (numbness or tingling), or functional impairment.