Benign fibrous histiocytoma of bone in a paediatric population: a report of 6 cases

Benign Fibrous Histiocytoma of Larynx: A Rare Case Report

The Fibrous histiocytoma is one of the mesenchymal tumors that can present as malignant or benign. We reported a 30 years old male, a rare case of benign fibrous histiocytoma of larynx and evaluated the clinical and histological aspect of this patient.

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.

Non-ossifying fibromas: Case series, including in uncommon upper extremity sites

AIM

To investigate non-ossifying fibromas (NOFs) common fibrous bone lesions in children that occur in bones of the lower extremities.

METHODS

We analyzed 44 cases of NOF including 47 lesions, which were referred with a working diagnosis of neoplastic lesions. Lesions were located in the upper extremities (1 proximal humerus, 1 distal radius) and the lower extremities (25 distal femurs, 12 proximal and 4 distal tibias, and 4 proximal fibulas).

RESULTS

Three cases had NOFs in multiple anatomical locations (femur and fibula in 1 case, femur and tibia in 2 cases). Overall, larger lesions > 4 cm and lesion expansion at the cortex were seen in 21% and 32% of cases, respectively. Multiple lesions with bilateral symmetry in the lower extremities suggest that these NOFs were developmental bone defects. Two patients suffered from fracture and were treated without surgery, one in the radius and one in the femur. Lesions in the upper extremities (i.e., humerus of a 4-year-old female and radius of a 9-year-old male) expanded at the cortex and lesion size increased with slow ossification.

CONCLUSION

NOFs in the lower extremity had fewer clinical problems, regardless of their size and expansiveness. In these two upper extremity cases, the NOFs had aggressive biological features. It seems that there is a site specific difference, especially between the upper extremity and the lower extremity. Furthermore, NOFs in the radius are predisposed to fracture because of the slender structure of the radius and the susceptibility to stress.

Intraspinal extradural benign fibrous histiocytoma of the lumbar spine in a pediatric patient. Case report and literature review

INTRODUCTION

Benign fibrous histiocytoma (BFH) is a rare skeletal tumor. Spinal localizations have been previously described in 17 cases, and this is the first report of BFH occurring at the lumbar spine in a pediatric patient.

CASE REPORT

A 13-year-old male complained lower limb motor and sensory impairment with severe claudication and urination disorders. A huge intraspinal, extradural mass at L4-L5 level, clearly evident on a preoperative MRI, caused dislocation and severe compression of the cauda equina nerve roots. After a biopsy, confirming BFH, a tumor resection and L4-S1 vertebral arthrodesis was carried out. At 1 year follow-up, no recurrence was detached on postoperative MRI, with complete neurological recovery.

DISCUSSION AND CONCLUSION

Review of the literature is discussed. Histological examination is mandatory for a correct diagnosis and plan of treatment. None of the pediatric patients treated for BFH have ever shown local relapse.

Case for diagnosis

We report the case of an 11-year-old male patient with a histopathological and immunohistochemical diagnosis of dermatofibroma with an atypical clinical presentation on the right forearm. Although dermatofibroma is considered a benign skin tumor, some of its differential diagnoses, such as dermatofibrosarcoma protuberans and malignant fibrous histiocytoma, are truly aggressive. Lesions with atypical clinical aspects and topology associated with specific histopathological variants are some of the criteria for complete tumor excision.

Benign fibrous histiocytoma of a rib

Rib benign fibrous histiocytoma (BFH) is an uncommon entity. We came across a 20-year-old Chinese man who complained of right chest pain for 2 weeks. All laboratory examination results were normal. CT of the thorax revealed an expansible bone lesion in the right sixth anterior rib. Whole-body bone scan demonstrated intense tracer uptake in the lesion without other abnormalities. The patient underwent en bloc resection. Pathological diagnosis confirmed the diagnosis of rib BFH. This report underlines that when whole-body bone scan displays solitary uptake of a rib lesion, rib BFH should be considered in the differential diagnosis.