Head and Neck Imaging

Aggressive fibromatosis

(also called juvenile or infantile fibromatosis), locally invasive proliferation of fibrous tissue, with a musculo-aponeurotic origin. Aggressive fibromatosis typically occurs in children and young adults. The fibromatoses form a spectrum of proliferative fibrous lesions which are histologically difficult to classify. Aggressive fibromatosis resembles an extra-abdominal desmoid tumour. A typical feature is the tendency to recur after surgical resection. On CT it appears as mass lesion with variable enhancement (Fig.1); the signal characteristics on MRI are also variable.

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Fig.1

Axial CT images showing a large inhomogeneously enhancing mass lesion (arrows) in the left submandibular space, displacing the oropharynx (a); mandibular invasion with considerable bone destruction (b).
Aggressive fibromatosis, Fig.1 (a)
Aggressive fibromatosis, Fig.1 (b)