Fibroma physical examination: Difference between revisions

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{{CMG}}{{AE}} {{M.N}}, {{Simrat}}
{{CMG}}{{AE}} {{M.N}}, {{Simrat}}
==Overview==
==Overview==
Common [[physical examination]] findings of oral fibroma include [[sessile]], dome-shaped [[mass]], 1-2 cm in diameter, pale pink in color, and firm, non-tender on [[palpation]]. Common [[physical examination]] findings of [[non-ossifying fibroma]] include localized [[tenderness]] or [[swelling]] over a [[lesion]]. Common [[physical examination]] findings of cemento-ossifying fibromas include a [[sessile]] or [[pedunculated]] [[mass]],  may be [[Ulcerated lesion|ulcerated]] and generally has a diameter of less than 2 cm, and diffuse expansion of [[jaw]] on right [[maxillary]] [[posterior]] area, extending [[Anteroposterior|anteroposteriorly]] from [[distal]] of upper right [[second premolar]] to [[tuberosity]] region. Common [[physical examination]] findings of desmoplastic fibroma include [[tenderness]] over the affected area and [[palpable]] [[mass]] may be present<ref name="pmid23459513">{{cite journal| author=Nedopil A, Raab P, Rudert M| title=Desmoplastic fibroma: a case report with three years of clinical and radiographic observation and review of the literature. | journal=Open Orthop J | year= 2013 | volume= 8 | issue=  | pages= 40-6 | pmid=23459513 | doi=10.2174/1874325001307010040 | pmc=PMC3583030 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23459513  }} </ref>
Common [[physical examination]] findings of oral fibroma include [[sessile]], dome-shaped [[mass]], 1-2 cm in diameter, pale pink in color, and firm, non-tender on [[palpation]]. Common [[physical examination]] findings of [[non-ossifying fibroma]] include localized [[tenderness]] or [[swelling]] over a [[lesion]]. Common [[physical examination]] findings of cemento-ossifying fibromas include a [[sessile]] or [[pedunculated]] [[mass]],  may be [[Ulcerated lesion|ulcerated]] and generally has a diameter of less than 2 cm, and diffuse expansion of [[jaw]] on right [[maxillary]] [[posterior]] area, extending [[Anteroposterior|anteroposteriorly]] from [[distal]] of upper right [[second premolar]] to [[tuberosity]] region. Common [[physical examination]] findings of desmoplastic fibroma include [[tenderness]] over the affected area and [[palpable]] [[mass]] may be present.


==Physical Examination==
==Physical Examination==
==Oral Fibroma==
==Oral Fibroma==
===HEENT===
===HEENT===
*[[Oral fibroma]] appears as a sessile, dome-shaped mass with a smooth surface.  
*[[Oral fibroma]] appears as a [[sessile]], dome-shaped [[mass]] with a smooth surface.
*The size of the lesion may range from 1-2 centimeters in diameter.
*The size of the [[lesion]] may range from 1-2 centimeters in diameter.
*Oral fibroma is usually pale pink in color. Occasionally, the lesion may appear reddish.  
*Oral fibroma is usually [[Pale skin|pale]] pink in color. Occasionally, the [[lesion]] may appear reddish.
*If traumatized, ulceration on the surface may be noted.
*If [[Trauma|traumatized]], [[ulceration]] on the surface may be noted.
*Oral fibroma is firm upon palpation and exhibits a well-defined periphery and usually non tender on palpation.
*Oral fibroma is firm upon [[palpation]] and exhibits a well-defined [[periphery]] and usually non-tender on [[palpation]].
==Chondromyxoid Fibroma==
==Chondromyxoid Fibroma==
===Extremities===
===Extremities===
The proximal tibia metaphysis is the most common location, followed by the distal femoral [[metaphysis]].<ref name="pmid8590888">{{cite journal| author=Wu KK| title=Chondromyxoid fibroma of the foot bones. | journal=J Foot Ankle Surg | year= 1995 | volume= 34 | issue= 5 | pages= 513-9 | pmid=8590888 | doi=10.1016/S1067-2516(09)80030-6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8590888  }} </ref>
The [[proximal]] [[tibia]] [[metaphysis]] is the most common [[Location parameter|location]], followed by the [[distal]] [[femoral]] [[metaphysis]].<ref name="pmid8590888">{{cite journal| author=Wu KK| title=Chondromyxoid fibroma of the foot bones. | journal=J Foot Ankle Surg | year= 1995 | volume= 34 | issue= 5 | pages= 513-9 | pmid=8590888 | doi=10.1016/S1067-2516(09)80030-6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8590888  }} </ref>
*Patients may have localized tenderness or swelling over a lesion  
*[[Patients]] may have localized [[tenderness]] or [[swelling]] over a [[lesion]]
*A pathologic fracture may be present
*A [[Pathological|pathologic]] [[fracture]] may be present
==Non-ossifying Fibroma==
==Non-ossifying Fibroma==
===Extremities===
===Extremities===
*Large [[non-ossifying fibroma]] may cause localized tenderness or swelling over a lesion and/or pathologic fracture in the long bones.<ref name="pmid23008139">{{cite journal| author=Bowers LM, Cohen DM, Bhattacharyya I, Pettigrew JC, Stavropoulos MF| title=The non-ossifying fibroma: a case report and review of the literature. | journal=Head Neck Pathol | year= 2013 | volume= 7 | issue= 2 | pages= 203-10 | pmid=23008139 | doi=10.1007/s12105-012-0399-7 | pmc=PMC3642261 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23008139  }} </ref>
*Large [[non-ossifying fibroma]] may cause localized [[tenderness]] or [[swelling]] over a [[lesion]] and/or [[Pathological|pathologic]] [[fracture]] in the [[long bones]].<ref name="pmid23008139">{{cite journal| author=Bowers LM, Cohen DM, Bhattacharyya I, Pettigrew JC, Stavropoulos MF| title=The non-ossifying fibroma: a case report and review of the literature. | journal=Head Neck Pathol | year= 2013 | volume= 7 | issue= 2 | pages= 203-10 | pmid=23008139 | doi=10.1007/s12105-012-0399-7 | pmc=PMC3642261 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23008139  }} </ref>
==Desmoplastic Fibroma==
==Desmoplastic Fibroma==
===Extremities===
===Extremities===
*Tenderness over the affected area  
*[[Tenderness]] over the affected area
*Palpable mass may be present<ref name="pmid23459513">{{cite journal| author=Nedopil A, Raab P, Rudert M| title=Desmoplastic fibroma: a case report with three years of clinical and radiographic observation and review of the literature. | journal=Open Orthop J | year= 2013 | volume= 8 | issue=  | pages= 40-6 | pmid=23459513 | doi=10.2174/1874325001307010040 | pmc=PMC3583030 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23459513  }} </ref>
*[[Palpable]] [[mass]] may be present<ref name="pmid23459513">{{cite journal| author=Nedopil A, Raab P, Rudert M| title=Desmoplastic fibroma: a case report with three years of clinical and radiographic observation and review of the literature. | journal=Open Orthop J | year= 2013 | volume= 8 | issue=  | pages= 40-6 | pmid=23459513 | doi=10.2174/1874325001307010040 | pmc=PMC3583030 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23459513  }} </ref>
==Ossifying Fibroma==
==Ossifying Fibroma==
===Extremities===
===Extremities===
*Localized pain or pathological fracture may be present
*Localized [[pain]] or [[pathological]] [[Fracture (bone)|fracture]] may be present
*Localized firm swelling of the tibia may be present
*Localized firm [[swelling]] of the [[tibia]] may be present
===HEENT===
===HEENT===
*Intraoral examination may reveal diffuse expansion of jaw, if mandible is involved.
*Intra-oral [[examination]] may reveal [[diffuse]] expansion of [[jaw]], if [[mandible]] is involved.
*Swelling in the affected region is the most common clinical sign observed in patients with OF.
*[[Swelling]] in the affected region is the most common [[Clinical signs|clinical sign]] observed in [[patients]] with ossifying fibroma.
*[[Ossifying Fibroma]] of jaw may cause tooth displacement and root resorption in adjacent teeth.<ref name="KashyapNair2011">{{cite journal|last1=Kashyap|first1=Roopashri Rajesh|last2=Nair|first2=Gopakumar R.|last3=Gogineni|first3=Subhas Babu|title=Asymptomatic Presentation of Aggressive Ossifying Fibroma:A Case Report|journal=Case Reports in Dentistry|volume=2011|year=2011|pages=1–4|issn=2090-6447|doi=10.1155/2011/523751}}</ref><ref name="AndradeSilva-Sousa2013">{{cite journal|last1=Andrade|first1=Marcia de|last2=Silva-Sousa|first2=Yara Teresinha Correa|last3=Marques|first3=Maria Fernanda Teiga|last4=Pontual|first4=Maria Luiza dos Anjos|last5=Ramos-Perez|first5=Flavia Maria de Moraes|last6=Perez|first6=Danyel Elias da Cruz|title=Ossifying Fibroma of the Jaws: A Clinicopathological Case Series Study|journal=Brazilian Dental Journal|volume=24|issue=6|year=2013|pages=662–666|issn=0103-6440|doi=10.1590/0103-6440201302364}}</ref>
*[[Ossifying Fibroma]] of [[jaw]] may cause [[tooth]] [[displacement]] and root [[resorption]] in adjacent [[teeth]].<ref name="KashyapNair2011">{{cite journal|last1=Kashyap|first1=Roopashri Rajesh|last2=Nair|first2=Gopakumar R.|last3=Gogineni|first3=Subhas Babu|title=Asymptomatic Presentation of Aggressive Ossifying Fibroma:A Case Report|journal=Case Reports in Dentistry|volume=2011|year=2011|pages=1–4|issn=2090-6447|doi=10.1155/2011/523751}}</ref><ref name="AndradeSilva-Sousa2013">{{cite journal|last1=Andrade|first1=Marcia de|last2=Silva-Sousa|first2=Yara Teresinha Correa|last3=Marques|first3=Maria Fernanda Teiga|last4=Pontual|first4=Maria Luiza dos Anjos|last5=Ramos-Perez|first5=Flavia Maria de Moraes|last6=Perez|first6=Danyel Elias da Cruz|title=Ossifying Fibroma of the Jaws: A Clinicopathological Case Series Study|journal=Brazilian Dental Journal|volume=24|issue=6|year=2013|pages=662–666|issn=0103-6440|doi=10.1590/0103-6440201302364}}</ref>
==Cemento-ossifying fibroma==
==Cemento-ossifying fibroma==
===Appearance of the patient===
===Appearance of the patient===
*Extraorally, lesion presented as fullness with ill-defined borders on right lower 2/3rd of the face.<ref name="KashyapNair2011">{{cite journal|last1=Kashyap|first1=Roopashri Rajesh|last2=Nair|first2=Gopakumar R.|last3=Gogineni|first3=Subhas Babu|title=Asymptomatic Presentation of Aggressive Ossifying Fibroma:A Case Report|journal=Case Reports in Dentistry|volume=2011|year=2011|pages=1–4|issn=2090-6447|doi=10.1155/2011/523751}}</ref>
*Extraorally, [[lesion]] presented as fullness with ill-defined borders on right lower 2/3rd of the [[face]].<ref name="KashyapNair2011">{{cite journal|last1=Kashyap|first1=Roopashri Rajesh|last2=Nair|first2=Gopakumar R.|last3=Gogineni|first3=Subhas Babu|title=Asymptomatic Presentation of Aggressive Ossifying Fibroma:A Case Report|journal=Case Reports in Dentistry|volume=2011|year=2011|pages=1–4|issn=2090-6447|doi=10.1155/2011/523751}}</ref>
===HEENT===
===HEENT===
*A sessile or pedunculated mass may be present on intraoral examination
*A [[sessile]] or [[pedunculated]] [[mass]] may be present on intraoral [[examination]]
*Mass may be ulcerated and generally has a diameter of less than 2 cm.
*[[Mass]] may be [[Ulcerated lesion|ulcerated]] and generally has a diameter of less than 2 cm.
*Intraoral examination may reveal diffuse expansion of jaw on right maxillary posterior area, extending anteroposteriorly from distal of upper right second premolar to tuberosity region.
*Intraoral [[examination]] may reveal [[diffuse]] expansion of [[jaw]] on right [[maxillary]] [[posterior]] area, extending [[Anteroposterior|anteroposteriorly]] from [[distal]] of upper right [[second premolar]] to [[tuberosity]] region.


==References==
==References==

Latest revision as of 16:48, 31 July 2019

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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]

Overview

Common physical examination findings of oral fibroma include sessile, dome-shaped mass, 1-2 cm in diameter, pale pink in color, and firm, non-tender on palpation. Common physical examination findings of non-ossifying fibroma include localized tenderness or swelling over a lesion. Common physical examination findings of cemento-ossifying fibromas include a sessile or pedunculated mass, may be ulcerated and generally has a diameter of less than 2 cm, and diffuse expansion of jaw on right maxillary posterior area, extending anteroposteriorly from distal of upper right second premolar to tuberosity region. Common physical examination findings of desmoplastic fibroma include tenderness over the affected area and palpable mass may be present.

Physical Examination

Oral Fibroma

HEENT

Chondromyxoid Fibroma

Extremities

The proximal tibia metaphysis is the most common location, followed by the distal femoral metaphysis.[1]

Non-ossifying Fibroma

Extremities

Desmoplastic Fibroma

Extremities

Ossifying Fibroma

Extremities

HEENT

Cemento-ossifying fibroma

Appearance of the patient

  • Extraorally, lesion presented as fullness with ill-defined borders on right lower 2/3rd of the face.[4]

HEENT

References

  1. Wu KK (1995). "Chondromyxoid fibroma of the foot bones". J Foot Ankle Surg. 34 (5): 513–9. doi:10.1016/S1067-2516(09)80030-6. PMID 8590888.
  2. Bowers LM, Cohen DM, Bhattacharyya I, Pettigrew JC, Stavropoulos MF (2013). "The non-ossifying fibroma: a case report and review of the literature". Head Neck Pathol. 7 (2): 203–10. doi:10.1007/s12105-012-0399-7. PMC 3642261. PMID 23008139.
  3. Nedopil A, Raab P, Rudert M (2013). "Desmoplastic fibroma: a case report with three years of clinical and radiographic observation and review of the literature". Open Orthop J. 8: 40–6. doi:10.2174/1874325001307010040. PMC 3583030. PMID 23459513.
  4. 4.0 4.1 Kashyap, Roopashri Rajesh; Nair, Gopakumar R.; Gogineni, Subhas Babu (2011). "Asymptomatic Presentation of Aggressive Ossifying Fibroma:A Case Report". Case Reports in Dentistry. 2011: 1–4. doi:10.1155/2011/523751. ISSN 2090-6447.
  5. Andrade, Marcia de; Silva-Sousa, Yara Teresinha Correa; Marques, Maria Fernanda Teiga; Pontual, Maria Luiza dos Anjos; Ramos-Perez, Flavia Maria de Moraes; Perez, Danyel Elias da Cruz (2013). "Ossifying Fibroma of the Jaws: A Clinicopathological Case Series Study". Brazilian Dental Journal. 24 (6): 662–666. doi:10.1590/0103-6440201302364. ISSN 0103-6440.

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