Bilateral collagenous fibroma of the hard palate: a case report and review of the literature.

BACKGROUND: Collagenous fibroma or desmoplastic fibroblastoma is a rare benign fibrous tissue tumor. It usually presents as a painless, slowly growing mass. Collagenous fibroma arises ordinarily inside the subcutaneous tissues or skeletal muscles. Histopathologically, the tumor consists of scattered stellate and spindle cells in a hypovascular collagenous stroma without atypia or infiltration. The oral cavity is a very uncommon site for desmoplastic fibroblastoma. Only 15 published articles in the literature reported the intraoral location. We present a case of collagenous fibroma with a bilateral distribution on the hard palate. This is the second case of bilateral collagenous fibroma after a previously reported one in literature; however, our case was larger, occupying almost the whole palate. We discuss the management of this rare tumor and how we can reach definite diagnosis. CASE PRESENTATION: A 37-year-old Caucasian female patient had a huge bilateral firm palatal mass that caused breathing problems. There was no history of trauma and the patient had no relevant medical history Total surgical excision under general anesthesia was carried out and histopathological examination suggested a benign mesenchymal tumor. Immunohistochemistry was necessary to confirm the tumor origin and to exclude aggressive fibromatosis. A diagnosis of bilateral collagenous fibroma was reached. Six months after surgery, there was no recurring lesion and the patient's health was good. CONCLUSIONS: Collagenous fibroma is a benign fibrous tissue tumor of unknown cause that is treated with simple excision. The prognosis is good with no recurrence. Reaching an accurate diagnosis is mandatory to avoid aggressive treatment since collagenous fibroma may be misdiagnosed as aggressive fibromatosis in case of massive size. Clinicians and pathologists should be aware of this unusual tumor for conservative management without side effects.

Evaluation of orbital volume after orbitozygomatic complex fractures fixation: A radiographical study.

BACKGROUND: Orbitozygomatic complex fractures are one of the most commonly encountered injuries of the craniofacial skeleton. The aim of this study was to implement the orbital volume as an objective evaluation modality for the assessment of the accuracy of unilateral Orbitozygomatic complex fracture fixation, by comparing the postoperative values with the contralateral normal side and the pretreated values. MATERIALS AND METHODS: A retrospective radiographic, chart review was performed in order to investigate the primary outcome of the objective quantification of the accuracy of Orbitozygomatic complex fracture reduction utilizing orbital volume analysis. Comparing the postoperative orbital volume values with the preoperative, and the contralateral normal ones was set as the study secondary outcome, along with the percentage of changes in the orbital volume of unilateral Orbitozygomatic complex fracture treated patients. Data reliability was performed using Interclass correlation coefficient and Statistical significance was set at 5% level. RESULTS: Seventeen records met the inclusion criteria. While a statistically significant difference was found between the preoperative orbital volume values of the affected side and that in the normal unaffected side (P < 0.001), a statistically insignificant difference was encountered between the postoperative values and the control side (P = 0.333). An average percentage of decrease of 6.1%. was reported in the postoperative records when compared to the preoperative ones, with a statistically significant difference (P < 0.001). the study reported high inter (ICC = 0.97) and Intra (ICC = 0.97) observer reliability. CONCLUSION: Orbital volume analysis offers a valid modality for the objective evaluation of the efficiency of Orbitozygomatic complex fracture management.