Pediatric fibroma in maxillary sinus following nasal trauma: A case report

Fibroma is a benign tumor of the connective tissue and is classified among the fibrous and fibrous histiocytic lesions. In the pediatric age group, both the differential diagnosis and surgery of maxillary swellings are difficult.

A 26-month old girl applied with swelling and malformation in the nose. She complained of swelling in the right cheek, nasal obstruction and dyspnea during the night time. Her family stated that she had a head trauma 45 days before the application. We observed a rigid mass in the lateral side of the right nasal region consistent with severe edema. The pediatric endoscopic examination displayed a passage obstruction and an expansion of the lateral wall towards the septum. We performed right Caldwell-Luc approach with the endoscopic transnasal approach. The pathological examination with the light microscope displayed dense and thick collagen fibers and fusiform fibroblasts mixed up with these collagen fibers.

Fibroma and fibroma like lesions are rare and difficult to diagnose. In the Pubmed database, we did not encounter any large-scale study focused on this type of tumors except for some case reports of fibromyxoma. In respect of the findings in the literature, along with the pathological criteria, the clinicopathological correlation and radiological imaging may facilitate the diagnosis. Furthermore, a good cooperation with the patient and his/her family and a reliable history like trauma are also critical.

The possibility of trauma should be definitively questioned during the history of pediatric patients, who applied with a maxillofacial swelling with the presence of persistent edema and differential diagnosis for the soft tissue tumors like fibroma should be considered.