Subcutaneous Benign Fibrous Histiocytoma: Rare Presentation on Cheek-Case Report and Review of Literature

"Unusual Presentation of Epitheloid Dermatofibroma- Rare Case Report"

Dermatofibroma is a commonly occurring cutaneous entity usually centered within the skin's dermis. Dermatofibromas are referred to as benign fibrous histiocytomas of the skin, superficial/cutaneous benign fibrous histiocytomas, or common fibrous histiocytoma. These mesenchymal cell lesions of the dermis clinically are firm subcutaneous nodules that occur on the extremities in the vast majority of cases and may or may not be associated with overlying skin changes. A 20 years old male presented to ENT OPD, at a private hospital, with complaints of a huge mass over right side of face since 15 years, which was slowly growing and not associated with pain. On clinical examination, hard, non tender, lobulated cauliflower like mass located over right side of face extending from right side temporal region to upper border of mandible from superior to inferior. From anterior to posterior it was extending from lateral 1/3rd of forehead and covering lateral canthus of right eye upto right side tragus. We have taken incisional biopsy which was suggestive of dermatofibroma. Then surgery was performed with patient's consent. Excision with 1 cm free margin was done. Raw area was covered with full thickness skin grafting and advancement flap. We found no recurrence till date. Dermatofibroma in the head and neck region is less common and often present a difficult differential diagnosis like Dermatofibrosarcoma protuberans, Kaposi Sarcoma, Basal cell carcinomas. The aim of case report is to represent case of dermatofibroma of epitheloid variety which is unusual in size.

A Case Report of a Benign Fibrous Histiocytoma: A Post-mosquito Bite Reaction

Fibrous histiocytomas can be differentiated into malignant fibrous histiocytoma or benign fibrous histiocytoma (BFH) and may involve soft tissue and hard bony tissue. A BFH is a rare group of tumors involving fibrocystic and histiocytic elements. Although BFH after a mosquito bite is rare, it must be a part of the differential diagnosis in unresponsive cases of insect bite reactions. A 57-year-old woman with a history of hypertension arrived at the clinic to discuss an 18-year-old lump in her left leg. The patient described the mass as painless and immobile on the anterior part of the left leg. She stated that it had started with a mosquito bite 18 years ago. The woman visited the clinic after her cat scratched the nodule and the erythema on the anterior area of her leg intensified. Physical examination revealed a 10 × 5 × 5 cm solid, stemmed, non-tender mass with erythema on the left leg. A CT scan revealed a stemmed soft tissue mass with well-defined borders. BFH is one of the common types of histiocytoma that is differentiated based on location, which can be dermis, subcutaneous tissue, and deep soft tissues. BFH is predominantly common in young-to-middle-aged females compared to males. BFH can emerge anywhere on the body. However, the occurrence on the lower extremities is high. This case is presented for its rarity and uncommon site of involvement and the significant clinical presentation and emerging condition following a mosquito bite.

Benign fibrous histiocytoma of the oral and maxillofacial region: A systematic review

OBJECTIVE

The aim of the present study was to carry out a systematic review of available data regarding case reports and case series of oral and maxillofacial benign fibrous histiocytoma (BFH).

STUDY DESIGN

A search strategy was performed using the PubMed, Web of Science, Scopus, and EMBASE electronic databases.

RESULTS

Male individuals (56.89%) were more affected, with a mean age of 34.55 ± 20 years. The buccal mucosa (20.33%) represented the most common site, with the clinical presentation of a painless (86.95%) nodule (98.03%). The clinical hypothesis of a fibroma was reported in most cases (31.57%). Radiographic presentation of intraosseous lesions showed multilocular radiolucent images (55.55%). Regarding the histopathologic features, the biphasic population of fibroblastic and histiocytic cells was seen in 21 cases (39.62%), and a spindle-shaped fibroblastic cell population organized into a storiform pattern was observed in 25 cases (47.16%). CD68 (n = 26) and vimentin (n = 25) showed immunoreactivity in all BFH cases in which they were used. All cases were treated with a surgical resection, and 8.10% recurred.

CONCLUSIONS

The current systematic review demonstrated that BFH represents a rare lesion that mainly affects the buccal mucosa of male individuals, and the treatment is mainly surgical with a good prognosis.

Fibromyxoma of the Tarsus: A Case Report

A 61-year-old woman presented with a slow-growing mass on the right upper eyelid. The hard, fixed, and nontender mass was apparent on the right upper eyelid. It was immobile, and it seemed to be adhered to the tarsus. Total excision of the mass was performed. A histopathological examination revealed a solid mass with fibrous and myxoid areas with scattered spindle- to stellate-shaped cells in a fibromyxoid matrix. The immunochemistry examination stained positively for CD34 and CD99. Based on these findings, the lesion was diagnosed as a tarsal fibromyxoma. Although rare, a fibromyxoma originating from the tarsus should be considered in the differential diagnosis of solid tarsal lesions.