Repetitive trauma-induced extra-nuchal-type fibroma

Area of Science:

• Dermatology
• Orthopedics
• Radiology

Background:

• Nuchal-type fibromas are rare, benign fibrous tumors.
• Typically found in the posterior neck, they can occur in extra-nuchal sites like the back, shoulder, and face.
• Repetitive trauma is a sparsely reported cause for these tumors.

Purpose of the Study:

• To present a biopsy-proven case of an extra-nuchal fibroma.
• To suggest sustained high pressure as a contributing factor in addition to repetitive trauma.
• To describe imaging characteristics and review literature for diagnosis and differential diagnoses.

Main Methods:

• Case report of a biopsy-proven fibroma.
• Detailed description of patient's activity leading to the lesion (heavy gym-related activities, barbell pressure).
• Review of ultrasound and MRI imaging characteristics, current literature, and differential diagnoses.

Main Results:

• A biopsy-proven fibroma was identified in the subcutaneous tissues of the posterior neck.
• The lesion arose from sustained pressure from a barbell during leg squatting.
• Ultrasound and MRI findings were documented.

Conclusions:

• Sustained high pressure, in addition to repetitive trauma, may cause extra-nuchal fibromas.
• This case, though in the posterior neck, was classified as extra-nuchal due to subcutaneous containment.
• Imaging characteristics are provided to aid diagnosis.