Desmoid fibromatosis cannot be considered a biologically benign or innocuous lesion. In the head and neck it may be intraosseous (desmoplastic fibroma) or, more often, in soft tissues, with the highest incidence in the supraclavicular region of the neck. High recurrence and persistence rates, 50% or more, accompany intralesional or marginal excision. Keloids and proliferative scars, while stubborn in their resolution and potentially disfiguring, are reactive proliferative disorders of fibroblastic and myofibroblastic tissues.