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Fibromas: Causes, Symptoms & Treatment
Fibromas are benign tumors composed of connective tissue that can develop anywhere in the body. They are usually harmless but may cause symptoms depending on their location.
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Fibromas are benign tumors composed of connective tissue that can develop anywhere in the body. They are usually harmless but may cause symptoms depending on their location.
What Are Fibromas?
Fibromas (singular: fibroma) are benign tumors that arise from connective tissue cells known as fibroblasts. They can develop in virtually any tissue in the body that contains connective tissue, including the skin, internal organs, muscles, and mucous membranes. In most cases, fibromas grow slowly or not at all and have no tendency to become malignant. Cancerous transformation is extremely rare.
Types of Fibromas
Fibromas are classified based on their location and tissue composition:
- Skin fibromas (dermatofibromas): Small, firm nodules in or beneath the skin, most commonly found on the legs. They are typically brownish or reddish in color.
- Uterine fibromas (myomas / leiomyomas): Benign tumors of the uterus composed of muscle and connective tissue. They are among the most common benign tumors in women.
- Soft tissue fibromas: Occur in soft tissues such as fatty tissue or deeper skin layers.
- Oral fibromas: Benign mucosal growths in the mouth, often caused by chronic irritation.
- Fibromas of joints and tendons: May cause restricted movement or discomfort.
Causes
The exact causes of fibroma formation are not fully understood. The following factors are discussed:
- Hormonal influences: Particularly in uterine fibromas, estrogens play a significant role. Fibromas often grow during pregnancy and regress after menopause.
- Genetic predisposition: A familial tendency has been observed.
- Chronic irritation: For example, from dental prostheses or bite injuries in the oral cavity.
- Trauma or inflammation: May act as triggering factors.
Symptoms
Many fibromas cause no symptoms and are discovered incidentally. Depending on their size and location, the following symptoms may occur:
- Visible or palpable lumps under the skin
- Pressure pain or tenderness on touch
- In uterine fibromas: heavy menstrual bleeding, pelvic pain, frequent urination, or back pain
- Restricted movement when fibromas affect joints or tendons
- Difficulty swallowing or voice changes when located in the throat or neck area
Diagnosis
The diagnosis of a fibroma is typically established through:
- Physical examination: Palpation of the affected area
- Ultrasound (sonography): Commonly used for uterine and abdominal fibromas
- MRI (magnetic resonance imaging): Provides detailed information about size and location
- Biopsy: Tissue sampling for histological analysis when malignancy needs to be excluded
Treatment
Treatment depends on the type, size, and location of the fibroma, as well as the severity of symptoms:
- Watchful waiting: For small, asymptomatic fibromas, regular monitoring without intervention is often recommended.
- Surgical removal (excision): Indicated when fibromas cause symptoms or are cosmetically bothersome.
- Medication therapy: In uterine fibromas, hormonal medications (e.g., GnRH analogues) can be used to suppress growth.
- Uterine artery embolization: A minimally invasive procedure for uterine fibromas in which the blood supply to the fibroma is blocked.
- Laser treatment: Applicable especially for skin fibromas.
References
- Stewart EA. Uterine fibroids. New England Journal of Medicine. 2015;372(17):1646–1655.
- Pschyrembel Clinical Dictionary. 268th edition. De Gruyter, Berlin 2020.
- American College of Obstetricians and Gynecologists (ACOG). Uterine Fibroids. Practice Bulletin No. 228, 2021.
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