Aggressive Fibromatosis Arising after Facial Cosmetic Surgery

Abstract

Introduction: Fibromatosis is a rare benign neoplasm that infrequently presents in the head and neck. Although it has no metastatic potential, its ability to infiltrate and invade organs and vital structures can lead to significant morbidity and even death. Clinically, fibromatoses manifest as painless, firm, often rapidly growing masses fixed to underlying bone and soft tissue. Although the precise etiology is unknown, genetic mutations or hormonal levels may be a causative factor. Interestingly, trauma and surgical incisions may be associated in up to 25% of cases. Materials and Methods: A 44-year-old woman was treated for submental lipomatosis and platysmal banding via submental liposuction and platysmaplasty. Within the following weeks, a firm, nontender, freely-movable nodule was noted, and biopsy was returned as fibromatosis. Results: Because of the rapid progression and location of the tumor, this neoplasm was classified as aggressive fibromatosis. Our patient required surgical resection with close follow-up. Although reported in the head and neck prior to this case, this is the only case to our knowledge arising clinically after cosmetic surgery. Conclusions: Although the exact etiology is unknown, there is a strong suspicion that either the surgery itself may have been the causative factor enabling the normal reparative fibroblasts to differentiate into tumor cells or a preexisting, but not clinically apparent tumor, may have been stimulated by the procedure. Judicious follow-up and prompt diagnosis led to early treatment, which in turn decreased the potential for severe morbidity.