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FIBROMA

Fibroma
• Hyperplasia reaction of fibrous connective tissue to
local irritation or trauma
• A soft tissue mesenchymal benign lesion
• Incidence 12 per 1000 population
• Often occurs at the age of 20-30 years
• Comparison of women and men = 2: 1
• The size of this tumor is usually small, only 1
to 4 cm long, oval and symmetrical.
• Can enlarge over time
• Has limited growth and the size of the lesion
will decrease after the irritation or trauma
causes are removed.
Etiologi
• Internal Factors • Eksternal Factors
• Genetic • Long exposure to X-ray
• Low immunity and radionuclear rays
• Use of chemicals such as
arsenic, beryllium,
cadmium, mercury,
plumbum, and various
other heavy metals
• The presence of extensive
and long-standing
scarring. For example
scarring due to burns
Classification
1. Inflammatory fibrous hyperplasia (irritation
fibroma)
– most often in children
– often on the lips, buccal mucosa, tongue and
palate
– smooth surfaces are sometimes granular
2. Peripheral ossifying fibroma
– often on the gums, anterior molar region, and
interdental papillae
– smooth surface sometimes ulcerates
3. Neurofibroma
– autosomal dominan
– often on the tongue, gums, buccal and palate
mucosa
– nodule shaped
All of them aree asymptomatic, have clear
boundaries, are solid, color is the same as the
surrounding mucosa and develop slowly.
Diagnosis
• Lumps are pink
• Nodules with clear boundaries and often
pedunculated (sessile) or sessile (attached to the
mucosa and unable to move freely)
• Rarely with a diameter of more than 2 cm
• In some cases it can be white due to hyperkeratosis
from persistent irritation
• Commonly found, fibromas appear to be slightly
reddish in color and there is even ulceration if they
are still traumatized
• Cause pain
Treatment
Perawatan :
• Excision surgery on 1 mm of tissue around the lesion.
The shape of the excision is an ellipse (recurrence is
rare when the etiology is removed)
• For neurofibromas: there is no need for surgery if
there are no disturbing symptoms, but follow-up is
needed because 10% are at risk of becoming
malignant
Treatment
Pre-operation:
1. Check blood pressure, temperature, pulse
2. Psychological preparation for children and parents

Post-operation:
Give antibiotics, anti-inflammatory and analgesic drugs
Amoxicillin tab 250 mg no XV
S 3 dd I
Ibuprofen tab 200 mg no XII
S 3 dd 1,5
• Instruct patients to:

a. Control 3 days and 1 week post surgery


b. Can not consume foods that are too hot, sour and
spicy
c. If the stitches are loose, contact the doctor
immediately
Post-operasi
1st Control: (3 days post op)
• See the operating area
a. how to stitch in the area,
b. how are the signs of inflammation in the area (dolor,
heat, rubor and function)
c. if there is an infection, it can be irrigated with diluted
povidone iodine solution. Give additional antibiotics to
reduce infection.
2nd Control : (1 week post op)

• Look at the operating area, if the gingiva that has been cut
starts to blend with the gingiva next to it, and begins to show
signs of healing, the suture is opened / removed.
Complications: Fibrosarcoma (from
neurofibroma)

Prognosis: Good if the cause is eliminated


FIBROSARCOMA
Definition
• Only approximately 5% of all primary bone
sarcomas are fibrosarcoma.
• According to data compiled by the NCI in the
SEER database between the years 2000 – 2004,
the age-adjusted incidence of all bone and joint
sarcoma was 0.9 per 100,000 men and women
per year. Applying the previously published
incidence, approximately 1 case of fibrosarcoma
of bone is diagnosed annually for every two
million people.
Classification
• There are two main types: primary and
secondary.
Primary fibrosarcoma is a fibroblastic malignancy
that produces variable amounts of collagen.

Secondary fibrosarcoma of bone arises from a


preexisting lesion or after radiotherapy to an area
of bone or soft tissue. This is a more aggressive
tumor and has a poorer prognosis
• The occurrence of fibrosarcoma in conjunction
with metallic implants used for fracture
fixation or joint reconstruction has been
reported, albeit very rarely. The cause of this
transformation is unknown.
• Fibrosarcoma has also been noted to arise
from preexisting lesions, such as bone infarcts
and lesions associated with fibrous dysplasia,
chronic osteomyelitis, and Paget disease.
Etiology
• No definite cause of fibrosarcoma is known,
though genetic mutations may play a role.
• Current research indicates that many
sarcomas are associated with such mutations.
The more common genetic defects include
allele loss, point mutations, and chromosome
translocations.
Sign & Symptom
• The first symptom of fibrosarcoma is usually
pain but can however grow larger before the
pain is noticed.
• May cause swelling, benevolence, and may be
a lump may be visible.
• May include dilated blood vessels, limited
warmth, neurological and vascular changes
and pathological fractures.
Prognosis
• Primary fibrosarcoma of the bone has a worse
prognosis than osteosarcoma, with a 5-year
survival rate of 65%. In high-grade primary
fibrosarcoma, the 10-year survival rate is less
than 30%.
• Secondary fibrosarcoma is associated with a
very poor outcome, the survival rate at 10
years being less than 10%.
Diagnosis
Treatment

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