Benign nasal tumor appearing as neonatal respiratory distress. First reported case of nasopharyngeal fibrous histiocytoma

Benign fibrous histiocytoma with osteoclast-like giant cells in an infant

Benign fibrous histiocytoma is a common soft tissue tumor that usually occurs in adults and is relatively rare in childhood. This report describes a 7-month-old Caucasian boy with an enlarging firm congenital nodule on his occipital scalp. Histologic analysis revealed a benign fibrous histiocytoma with osteoclast-like giant cells. Benign fibrous histiocytoma with osteoclast-like giant cells is a rare histologic variant.

A pharyngeal hairy polyp causing neonatal airway obstruction: a case study

A case of neonatal respiratory distress due to an oropharyngeal hairy polyp is reported with its MRI assessment. The place of hairy polyps in the differential diagnosis of upper respiratory tract obstruction is discussed. Early and rapid diagnosis and treatment may be lifesaving for the newborn.

Malignant fibrous histiocytoma of the nasopharynx

Malignant Fibrous Histiocytomas (MFH) are uncommon in the head and neck and extremely rare in the nasopharynx. We report a case of MFH arising in the nasopharynx and describe its diagnosis and management. The literature is reviewed and the likely origins of the tumour and its behaviour are discussed.

Neonatal respiratory distress secondary to nasal fibrous histiocytoma

A full term one-day-old neonate developed respiratory distress secondary to a right intranasal mass. After exploratory craniotomy revealed no intracranial lesions, the child was observed for 6 months. At that time he experienced severe apnea with cyanosis necessitating removal of the mass, which was diagnosed histologically as a fibrous histiocytoma. Seven year follow-up reveals no further problems. A discussion of fibrous histiocytoma of the nose and paranasal sinuses is briefly given.

Congenital pleomorphic adenoma of the nasopharynx (report of a case)

A case of congenital salivary gland tumour occurring in the nasopharynx is reported. Congenital neoplasms of the head and neck (of any histological type) and congenital tumours of the nasopharynx are discussed and the literature is reviewed.

Fibrous histiocytomas of the oral and maxillofacial regions

Fibrous histiocytomas of the oral and maxillofacial regions are rare. The present study analyzes a sample of 63 cases from the literature together with 7 personally observed cases. Age, sex, site, size, clinical behaviour, treatment and survival were evaluated and related to a histological classification based on that of Rosai (1981). Lesions were assessed for histological criteria which would place them in one of 2 groups: fibrous histiocytoma (FH) or pleomorphic fibrous histiocytoma (PFH). Within these 2 histological groups the cases were subdivided into clinically benign, aggressive or malignant lesions. Thirty-nine cases (56.0%) were classified as FH and 31 cases (44.0%) as PFH. The mean age of male patients with PFH was significantly higher than female patients with FH (t = 3.05; d.f. 37; p less than 0.0025). Lesions in the PFH group involved bone more frequently than those in the FH group (Yate's Chi2 = 16.66; d.f. 1; p less than 0.00025). Lesions involving bone for both histological groups were more likely to be aggressive or malignant than soft-tissue lesions (Yate's Chi2 = 29.9; d.f. 1; p less than 0.00025). Soft-tissue lesions were usually less than 5 cm in greatest diameter. Radiographic features of malignancy for lesions with bone involvement is of prognostic importance regardless of the histological appearance of the lesion. The majority of the lesions under study were from the deep tissues of the oral and maxillofacial regions.

Fibrous histiocytoma of the nasal cavity and maxillary sinus

Two cases of fibrous histiocytoma were presented; Case 1: a 46-year-old man with a tumor filling the left nasal cavity and maxillary sinus, and Case 2: an 80-year-old man with a tumor of the right maxillary sinus destroying its surrounding wall. Histologically, the former was dominated by storiform pattern and onion-like structures, and the latter by osteoclast-like multinucleated giant cells. After radical surgery, Case 1 was free of recurrence for more than one year, and Case 2 showed recurrence although still maintaining fairly good health. A total of 29 cases hitherto reported arising in the nasal, paranasal and nasopharyngeal regions were reviewed, pitfall of differential diagnoses was commented especially in our two cases, criteria of malignancy were discussed, and the necessity of repeated samplings was emphasized because of paucity and unfamiliarity of fibrous histiocytoma arising, in particular, from the upper respiratory tract.

Fibrous histiocytomas of the oral mucosa

The oral lesions reported in this article fall into the first category of benign fibrous histiocytomas analogous to those which occur on sun-exposed skin surfaces of young objects. The ages of the patients, the histologic features and the history of traumatic episodes, as well as their biologic behaviors on follow-up, are all features compatible with those benign lesions which occur in the skin. According to the information presented in these cases, there is stronger evidence that the lesions of the oral mucosa, like their dermatologic counterparts, are representative of reactive inflammatory processes rather than neoplastic processes. It is of considerable interest that in both cases reported here the patients were children whose lesions developed following significantly severe traumatic episodes. Also of interest is the finding that the lesions healed with no recurrences or complications, even though in one of the cases it was not completely removed. These findings are in agreement with other reports of such lesions which have occurred in the head and neck regions of children and young adults. From the over-all information obtained in the literature review regarding the biologic behavior of benign fibro-histiocytic lesions, the collected data seem to indicate that lesions of the skin and superfacial mucosal surfaces which occur in children and young adults are proliferative, reactive lesions and infection, or irradiation. Systemic, visceral, or deep-seated lesions in the lower extremities appear to be true neoplasms and their prognoses must be considered as guarded.

Non-epithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx: a clinico-pathologic study XI. fibrous histiocytomas

As part of our review of non-epithelial tumors involving the nasal cavity, paranasal sinuses, and nasopharynx, nine fibrous histiocytomas (FH) are reported. FH probably are derived from undifferentiated mesenchymal stem cells that have the ability to differentiate into two different pathways, one fibroblastic and the other histiocytic. The proportion of these two different elements varies greatly in different lesions. The cell population ranges from cytologically benign (small bland nuclei and no mitoses) to overtly malignant (marked anaplasia and numerous mitoses). Based on our cases and on 12 previously reported tumors, FH involving the upper respiratory passages may cause clinical problems similar to those produced by other soft tissue neoplasms affecting this area, (nasal obstruction, a mass or swelling in the involved area, epistaxis, loosening of teeth, or facial pain). Physical examination may show a mass projecting into the nasal, sinus, or oral civity; facial asymmetry; proptosis; or a periorbital mass. Radiographic studies may demonstrate sinus opacification or cloudiness, a mass, or bone destruction. Treatment has included polypectomy, wide local excision, partial maxillectomy, or radical maxillectomy, depending on the size and extent of the lesion. When involving the upper respiratory passages, FH, if incompletely excised, may recur locally, requiring a more extensive resection. A minority of these tumors have metastasized via lymphatic and/or venous channels. Histologic features appear to correlate with clinical course.

Malignant fibrous histiocytoma of the maxillary sinus

A case of malignant fibrous histiocytoma arising primarily in the left maxillary sinus is described. The patient, a 39-year-old male, who had suffered from sinusitis for 20 years, began to have paresthesia or sharp pain of the left side of the face and toothaches of the left maxilla. At operation a white fibrous tumor developing extensively from the lateral wall to the upper and medial walls of the left maxillary sinus and into the ethmoidal sinus was noted. Following a gradual progression of dyspnea, he died approximately one year after the onset in spite of radiation therapy and anticancer chemotherapy. An autopsy revealed recurrence of the tumor in the left maxillary sinus with wide-spread metastases to the lungs, pleurae, pancreas, kidneys and bone marrows. The direct cause of death was respiratory failure due to extensive growths of the pulmonary and pleural metastases.

Fibrous histiocytoma of the subglottic larynx

Histiocytic tumors are being reported with increasing frequency in the medical literature. In spite of confusion regarding nomenclature, appropriate diagnostic and treatment modalities exist. A malignant fibrous histiocytoma of the subglottic larynx is reported. Discussion of the present criteria for a diagnosis of malignancy and a rationale of treatment is presented.