Atypical Nuchal-Type Fibromas: A Rare Presentation of the Soft Tissue Tumor in the Bilateral Lower Extremities

TL;DR

This paper reports a rare case of nuchal-type fibromas appearing bilaterally in the lower extremities of a 48-year-old male.

Contribution

The study presents the first known case of bilateral extra-nuchal nuchal-type fibromas in the lower extremities.

Findings

Nuchal-type fibromas are typically found in the posterior neck but are rare in other body regions.

This case involved bilateral masses in the ankle extensor retinacula confirmed by histopathology.

The patient's presentation is considered novel and among the first reported in medical literature.

Abstract

Nuchal-type fibromas (NTFs) are rare, benign tumors that predominantly originate in the posterior neck and often arise due to repetitive mechanical use. They are more common in males than females. Clinically, NTFs present as slow-growing, painless masses that are firm to the touch and immobile. The masses are typically not accompanied by other symptoms of erythema, warmth, or ulcerations as they are non-inflammatory in nature, with the possibility of tenderness in later stages of growth as nerves become entrapped in the tumor. Patients may present with cosmetic concerns and focal discomfort depending on the location and size of the mass. Extra-nuchal sites are uncommon, with locations reported in the literature including the upper back, shoulder, and face, with only one case reported where an NTF was found unilaterally on the ankle. We present a rare case of a 48-year-old male with bilateral masses in the ankle extensor retinacula, consistent with nuchal-type fibromas determined by histopathology. To our knowledge, our patient's presentation of bilateral extra-nuchal NTFs of the lower extremity is among the first to be reported in the literature.

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