Fibroepithelial neoplasm

Fibroepithelial neoplasm is a type of benign tumor that arises from both fibrous and epithelial tissue. These tumors are characterized by the presence of fibrous stroma and epithelial components, making them a distinct entity in the spectrum of soft tissue neoplasms. Fibroepithelial neoplasms can occur in various parts of the body but are most commonly found in the breast, where they are represented by fibroadenomas, and in the skin, where they manifest as skin tags or acrocordons. Other less common sites include the ovary, where fibrothecomas can develop, and the prostate gland, with fibroepithelial polyps being a rare occurrence.

Etiology and Pathogenesis

The exact cause of fibroepithelial neoplasms is not fully understood, but hormonal factors, particularly estrogen, are believed to play a significant role in their development, especially in the breast. Genetic predisposition and mechanical irritation are also considered contributing factors in the formation of these tumors in other locations.

Clinical Presentation

Fibroepithelial neoplasms typically present as painless, slow-growing masses. In the breast, fibroadenomas are usually mobile and well-defined, making them distinguishable from malignant tumors on physical examination. Skin tags are small, flesh-colored or slightly pigmented pedunculated lesions that commonly occur in areas of friction. Ovarian fibrothecomas may present with abdominal discomfort or distension, while fibroepithelial polyps of the prostate are often asymptomatic and discovered incidentally.

Diagnosis

The diagnosis of fibroepithelial neoplasms involves a combination of clinical examination, imaging studies, and histopathological evaluation. Mammography and ultrasound are commonly used to assess breast lesions, while dermatoscopy can aid in the evaluation of skin tags. Histological examination is crucial for confirming the diagnosis and ruling out malignancy, with biopsy or excision being the methods of choice.

Treatment

The treatment of fibroepithelial neoplasms depends on their location, size, and symptoms. Small, asymptomatic lesions may not require any treatment and can be observed over time. Surgical excision is the definitive treatment for symptomatic or enlarging tumors, ensuring complete removal and preventing recurrence. In the case of breast fibroadenomas, less invasive options such as cryoablation or laser ablation may be considered.

Prognosis

The prognosis for patients with fibroepithelial neoplasms is generally excellent, as these tumors are benign and have a low risk of malignant transformation. However, regular follow-up is recommended to monitor for changes in size or symptoms, particularly for lesions in the breast.