Nuchal and Gardner Fibroma
Elizabeth A. Montgomery, MD
Key Facts
Terminology
Uncommon fibrocollagenous lesion classically arising in cervicodorsal region
Some cases linked to familial adenomatous polyposis (FAP)/Gardner syndrome
Clinical Issues
Sporadic lesions usually in older men, often nuchal
Gardner-associated cases often involve trunk, head and neck, extremities of children; no gender predominance
Microscopic Pathology
Formless sheets of densely collagenized tissue with clefts and cracks
Hypocellular
Small nuclei
 At low magnification, this nuchal-type fibroma is loosely marginated, consisting of dense collagen. The lesion is hypocellular with an admixture of adipose tissue. |
 This nuchal-type fibroma is hypocellular, consisting of bland uniform cells. Note the cracked appearance of the dense collagen. |
TERMINOLOGY
Synonyms
Nuchal-type fibroma
Definitions
Uncommon fibrocollagenous lesion classically arising in cervicodorsal region
Not restricted to nuchal region
Hence term nuchal-type fibroma
Some cases linked to familial adenomatous polyposis (FAP)/Gardner syndrome
Germline APC gene mutations; colorectal polyposis and fibromatoses
CLINICAL ISSUES
Epidemiology
Incidence
Uncommon
Age
3rd-5th decades for sporadic lesions
Sporadic lesions often nuchal
Infants to adolescents for Gardner-associated cases
Mostly involve trunk, head and neck, extremities
Gender
Striking male predominance in sporadic cases
No gender predominance in Gardner-associated cases
