Fibroma is a general term for a benign tumor composed of connective tissue. They can grow almost anywhere in any organ, arising from mesenchyme tissue. When found in the soft tissue, they are generally self-limiting and present as painless, slow-growing, fairly well-demarcated, firm, encapsulated tumors. There are many types of fibroma based on what other elements are involved (e.g., fibrolipoma, fibrokeratoma, angiofibroma, fibromyxoma, xanthofibroma neurofibroma, etc.).

Surfer’s knob is a type of fibromas found on the dorsum of the feet as a result of repeated physical trauma from surfboard.

A slow-growing subcutaneous tumor of intermediate malignancy (can become metastatic)

Usually presents as a somewhat elevated, slightly protruding structure that is fixed to the skin and may have hyperpigmented and somewhat violaceous overlying skin. Most commonly seen in patients 30 to 50 years old. Males are affected more than females. Treatment involves excision with surrounding tissue; frozen sections may be necessary.

Periungual fibroma, also called a Koenen tumor, is a fibrous tumor seen in and around the nail bed and
nail folds. They are slow-growing flesh-colored, usually painless, nodular tumors that usually do not develop until puberty. These lesions are common in patients with tuberous sclerosis.

A fully malignant, infiltrative, metastatic tumor of fibroblastic origin. Presents as a slow-growing, lobulated, rubbery, firm mass with or without ulceration. Pain may or may not be present. They tend to metastasize to regional lymph nodes and have a high reoccurrence rate. Most often seen between ages 40 and 60 years in the thigh, knee, trunk, and forearm.

Treatment includes wide excision with surrounding normal tissue, chemotherapy, and irradiation. Amputation may be required. Survival depends on the histologic grade of the neoplasm.

Plantar fibromatosis is a benign reactive lesion of fibrous tissue. Usually presents as firm, single or multiple, lobular nodules, involving the medial aspect of the central bands of the plantar fascia of the foot. Plantar fibromatosis is more common in males and can be associated with other forms of fibromatosis such as its palmer equivalent Dupuytren disease and Peyronie disease, which is penile fibromatosis. While there are no clear pathophysiologic predictors for the condition, plantar fibromatosis may be associated with areas of repeated trauma, epilepsy, alcoholism, hypothyroidism, hypothyroidism, diabetes mellitus, and especially hereditary factors. Treatment is necessary only if the lesion is painful from pressure on surrounding structures. Conservative treatment includes padding and cortisone injections. Surgery involves radical resection with large margins of normal-appearing plantar fascia; reoccurrence rate is high.

Nodular fasciitis is a benign, self-limiting, fibroblastic proliferation most commonly seen in the forearm; lower extremity involvement is relatively uncommon. Lesions present as rapidly growing, firm, soft tissue nodules in the subcutaneous tissue. Symptoms are nonspecific and may be difficult to differentiate from fibrosarcoma. Occurs predominantly in patients aged 20 to 40 years. Pain may be present depending on involvement. Wide surgical excision to prevent reoccurrence is advised.

Leiomyomas are benign smooth muscle tumors found almost exclusively in adults. They are far more frequent in organ systems such as the gastrointestinal tract and the female genital system. When found in the soft tissue, leiomyomas are confined to the superficial subcutaneous tissue and skin. Treatment usually involves excision with
surrounding normal tissue. Basic types are as follows: