The Enclosed Leviathan- Pleomorphic Fibroma

Cutaneous pleomorphic fibroma was initially described by Kamino et al in 1989 as a dermal, pauci-cellular neoplasm with an abundant fibrous tissue stroma, atypical fibro-histiocytic cells and disseminated multinucleated giant cells(1). Pleomorphic fibroma is an exceptional, benign, polypoid ordome shaped, sparsely cellular, cutaneous fibroblastic neoplasm characteristically delineating aberrant, pleomorphic, hyperchromatic and giant multinucleated cells embedded in a collagenous stroma (2). Pleomorphic fibroma is contemplated to originate from dendrocytes, in contrast to myofibroblasts. The exceptional neoplasm can simulate adjunctive fibro-histiocytic, melanocytic or lipomatous neoplasia. Despite cellular and nuclear atypia accompanying pleomorphic, bizarre cells, the neoplasm is contemplated as architecturally and biologically benign, on account of exceptional or absent mitosis(2). Pleomorphic fibroma may be interlinked with sclerotic fibroma. Martin-Lopez defined the terminology “pleomorphic sclerotic fibroma” which posits pleomorphic fibroma, sclerotic fibroma and pleomorphic sclerotic fibroma as neoplasia representing a morphologic continuum (3).