Benign Fibrous Histiocytoma of the Sacrum: A Rare Scenario

Benign fibrous histiocytoma (BFH) of bone is quite rare, and here we report the second case of such tumor originating from sacrum, with the first being reported in an 18-year-old female. The overlapping clinical, radiological, and histopathological findings make it a difficult diagnosis along with the fact that it is a rare diagnosis. In this case report, we present the diagnostic difficulties and optimal treatment for such cases. A 46-year-old male w presented to OPD with complaint of numbness in left foot since 1 month, and intermittent urinary incontinence for 2 weeks. On examination, the straight leg raising test was positive of left side, extensor hallucis longus (EHL) was weak in both lower limbs, and bilateral ankle jerks were diminished. MRI showed well-defined lobulated solid mass lesion, which is T1 hypointense and T2 hyperintense and homogeneously involving the S1 vertebral body, with involvement of the right sacral ala, and right sacral foramen seen at S1 and S2 levels extending into the spinal canal till L4 level. Excision through a posterior midline incision was performed taking care to preserve the traversing nerves. Postoperatively, remarkable improvement in pain with no major residual neurological deficit was observed. Patient was followed-up till 9 months; patient’s incontinence improved over a period of 3 months and has stayed the same until the last follow-up.

Hyperpigmented Nodular Dermatofibroma: Two Cases Report and Brief Literature Review

BACKGROUND: Dermatofibroma (DF) is a common benign skin tumor (Benign Fibrous Histiocytoma) that mostly affects the extremities with a tendency to occur more often in older females than males. It usually presents as a slow growing small brown dome shape papule on the extremities. DF has a chronic nature and can sometimes regresses spontaneously. Dermoscopy is essential in the evaluation of DF to help differentiate it with other skin tumors. The gold standard evaluation for diagnosis of DF is biopsy with histopathologic examination. Removal of DF is often due to cosmetic factors, with surgical excision being the preferred method for removal. DF has an excellent prognosis. CASE REPORT: We present two case reports of women with hyperpigmented nodules on the lower extremity. Dimple sign was positive. From dermoscopic study showed a pigment network and central white patch pattern. On histologic examination revealed proliferation of fibroblast such as spindle cells as a storiform pattern and hyperplastic epidermis with hyperpigmentation of the basal layer. Based on clinical features, dermoscopy and histopathological evaluation, the diagnosis of DF was established. Both patients were perform surgically excision and have a good result. CONCLUSION: Dermatofibroma is benign fibrous histiocytoma that represents one of the most common skin tumours. Nodular hyperpigmented dermatofibroma is a clinical variant of Dermatofibroma which can be treated with surgical excision with good prognosis.

Benign fibrous histiocytoma of the femur: A rare pediatric case report

BACKGROUND: Benign fibrous histiocytoma is known to be a frequent skin tumor but its occurrence in bone remains very rare especially in pediatric population. This entity is a subject of interest also because histologically it can mimic other fibrohistiocytic lesions of bone such as non-ossifying fibroma. CLINICAL CASE: An 11-year-old patient admitted with swelling of the right thigh and intermittent pain. Radiological evaluation shows cystic lesion of the femur with a soap-bubble and a border of condensation. Histopathological examination of the biopsy sample established the diagnosis of benign fibrous histiocytoma. The patient underwent complete curettage of the lesion with bone graft. There is no recurrence 16 months after surgery. DISCUSSION: Benign fibrous histiocytoma is a rare bone tumor especially in children. Histologically it can mimic non-ossifying fibroma. Thus clinical and radiological features are important to differentiate these tumors in order to choose adequate treatment. CONCLUSIONS: Benign fibrous histiocytoma is probably underestimated in pediatric population. This diagnosis should be considered in any child or teenager who presents with a non-ossifying fibroma accompanied by unexplainable pain or a rapid growing.

Fibrous Histiocytoma of Anterior Ethmoidal Sinus: Case Report and Review of the Literature

Benign fibrous histiocytoma of the para nasal sinus is a rare tumor of this region which originates from mesenchymal cells. A 9-year-old girl presented with gradually enlarging mass above the medial canthus over 3 months. Orbital computerized tomography scan showed a round well-differentiated homogeneous mass in the anterior ethmoidal sinus. Histology and immunohistochemistry analysis after excision revealed proliferation of spindle-shaped fibroblasts in storiform pattern and histiocytes without mitosis and anaplasia. After 9 months from surgical excision, recurrence occurred which resulted in total excision again. This is the first reported case of benign fibrous histiocytoma involving the ethmoid sinus in Iranian people. Rare sinus tumor should be considered in the differential diagnosis of sinus tumors.

Aneurysmal pinna – An unfamiliar entity

Lesions ranging from cysts to benign and malignant tumors can affect the pinna. The clinical appearance, duration, progression, and histopathology of the lesion are important in differentiating non-neoplastic conditions from neoplasms. We present a case report of an unusual nodular pinna lesion that was excised under local anaesthesia. Histopathology revealed cutaneous aneurysmal fibrous histiocytoma. Aneurysmal benign fibrous histiocytoma is an unusual variant of soft tissue tumor with low intermediate malignant potential, which has to be differentiated from other benign and malignant tumors. Keywords: Benign fibrous histiocytoma; external ear; fibrous tissue neoplasms.