Fibroma

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Introduction

What is a fibroma?

A fibroma is a benign, tumor-like growth made up mostly of fibrous or connective tissue. Tumor-like growths such as fibroma develop when uncontrolled cell growth occurs for an unknown reason, or as a result of injury or local irritation. Fibromas can form anywhere in the body and usually do not require treatment or removal.

Fibromas can occur in people of any age and either sex, but they are most often seen in adults. The most common types of fibroma include angiofibromas (small papules across the nose and cheeks that contain fibrous tissue), dermatofibromas (benign skin growths), oral fibromas, and plantar fibromas (in the arch of the foot, especially in children). This article will focus on dermatofibromas (skin fibromas) and plantar (foot) fibromas.

Dermatofibromas are round growths, commonly found on the legs, that can range in color from flesh-colored to red-purple. They feel like hard lumps under the skin. Dermatofibromas are harmless and only rarely malignant, so they are best left alone.

A plantar fibroma is a nodule, or fibrous knot, embedded in the plantar fascia in the arch of the foot. The plantar fascia is a band of tissue that supports muscle and extends along the bottom of the foot from the heel to toes. Like dermatofibromas, plantar fibromas are typically benign, or nonmalignant. Primary treatment options are nonsurgical and are aimed at relieving pain while walking. Treatment options include steroid injections, orthotic devices, and physical therapy. If you continue to experience pain after trying these approaches, if the mass increases in size, or if your pain increases, surgical treatment is an option.

Neither dermatofibroma nor plantar fibroma is serious or life threatening. Seek prompt medical care for a fibroma that is persistent or causes you concern.

Symptoms

What are the symptoms of a fibroma?

The main symptom of a dermatofibroma is the presence of a small growth that may or may not be tender. It may be itchy or sensitive to the touch, and the color may change over time. Because it has a raised surface, it can be irritated by clothing or shaving and may bleed if it is damaged.

The main symptom of plantar fibroma is a lump in the arch of the foot that is firm to the touch and may or may not be painful. Pain is usually caused by pressure from shoes, although walking and standing while barefoot can also cause pain, depending on the size and location of the mass.

Common symptoms of a dermatofibroma

Symptoms related to discomfort from a dermatofibroma may come and go. Dermatofibroma symptoms are not severe and include:

  • Color that may change over time
  • Itchiness
  • Occasional tenderness
  • Possible bleeding with injury
  • Sensitivity of the dermatofibroma to touch
  • Small lump with a raised surface

Common symptoms of a plantar fibroma

Plantar fibroma symptoms are not severe and include:

  • Enlargement over time
  • Firm lump in the arch of the foot
  • Pain with pressure, standing or walking
  • Spread of additional fibromas over time

Symptoms that might indicate a serious condition

Neither dermatofibroma nor plantar fibroma is serious. However, in some cases, a plantar fibroma can become debilitating and require surgical intervention. It is important to keep in mind, however, that complications of surgery for plantar fibroma are often worse than the symptoms. Seek immediate medical care if you, or someone you are with, have any of these serious symptoms including:

Causes

What causes a fibroma?

The causes of dermatofibroma and plantar fibroma are not known. Some researchers believe that dermatofibromas may form as a localized tissue reaction following a minor injury. Plantar fibroma may have a genetic component, particularly in people of northern European descent. Some medications, including beta-blockers, have been reported to cause changes in fibrotic tissue.

What are the risk factors for a fibroma?

No definitive risk factors have been associated with either dermatofibroma or plantar fibroma, but some suspected risk factors include:

  • Family history of fibroma
  • Minor skin or foot injury
  • Northern European ancestry

Treatments

How is a fibroma treated?

Dermatofibromas are harmless, and treatment is not required unless there are disturbing symptoms or cosmetic concerns. Surgical treatment is an option if you wish to have your dermatofibroma removed. Be aware, the scarring and tissue changes that occur following surgical excision may look worse than the original bump.

For plantar fibroma, nonsurgical options are preferred because the surgical procedure requires a long recovery period and may lead to complications that can be worse than the plantar fibroma itself.

Noninvasive treatments for plantar fibroma

Noninvasive treatments for plantar fibroma include:

  • Extreme cold, or cryoanalgesia, to shrink the fibroma
  • Padding or orthotics to ease discomfort when wearing shoes
  • Stretching

Invasive treatments for plantar fibroma

Most physicians agree that it is wisest to reserve invasive treatments and surgeries for severe cases of plantar fibroma because the complications of surgery may be worse than the symptoms of plantar fibroma itself. Invasive treatments for plantar fibroma include:

  • Corticosteroid injections into the fibroma

  • Surgical removal of the entire plantar fascia (which is associated with a long recovery time and high risk of developing other foot problems)

  • Surgical removal of the fibroma (which has a high recurrence rate)

Treatments for an injured dermatofibroma

Treatment may be considered when dermatofibromas get in the way of shaving or are continually irritated. In these cases, surgical removal can be performed.

Treatments for damaged, intrusive or injured dermatofibromas include:

  • Liquid nitrogen freeze
  • Surgical removal

What are the potential complications of a fibroma?

Dermatofibroma has no serious complications. Complications from plantar fibroma are usually the result of surgical interventions. Although complications of invasive surgery for plantar fibroma are not usually serious, they can sometimes be more debilitating than the original fibroma. You can help minimize your risk of serious complications by following the postsurgical treatment plan you and your health care professional design specifically for you.

Complications of surgery for plantar fibroma include:

  • Flattening of the arch of the foot
  • Postsurgical plantar nerve entrapment
  • Postsurgical regrowth of larger and recurrent fibromas
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 4
  1. What are bone and soft tissue tumors? Seattle Children’s Hospital Research Foundation. http://www.seattlechildrens.org/medical-conditions/cancers-tumors/cancers-treatment/bone-tumors/.
  2. Soft tissue tumors - benign. Cedars-Sinai. http://www.cedars-sinai.edu/Patients/Health-Conditions/Soft-Tissue-Tumors---Benign.aspx.
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