Fibrous histiocytomas of the oral mucosa

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.

Clear Cell Dermatofibroma on the Chest Wall: A Case Report and Its Diagnostic Traps

Dermatofibromas are common lesions of the skin. Although they occur at any part of the body, they are most commonly observed on the lower legs of middle-aged women. The lesion comprises fibroblast-like cells, histiocytes, collagenous tissue, and blood vessels. Many histological variants have been defined based on the ratio of cell components and their location. These variants of dermatofibroma may cause problems during differential diagnosis between benign and malignant mesenchymal lesions of the skin and may lead pathologists to overdiagnose this lesion. Here, we report a case of clear cell dermatofibroma, which is a rare variant of dermatofibroma, together with its diagnostic traps.

Benign Fibrous Histiocytomas of the Oral Mucosa: Report on Three Cases and Review of the Literature

Benign fibrous histiocytomas (BFH) of the skin are common lesions, although they only rarely involve the oral mucosa. This article presents 3 additional cases of BFH of the oral mucosa, with a review of previously published cases. Although a malignant variant of BFH also exists, the present review focuses only on benign lesions. The clinical presentation, diagnosis, histopathological and immunohistochemical features of BFH are discussed. According to the present analysis, the majority of oral mucosal BFH have occurred in middle-aged and elderly patients, with a slight female predilection. Within the oral cavity, BHF may occur at any mucosal site, including the lips, tongue, buccal mucosa, mandibular and maxillary gingiva as well as the palate. Histopathology is essential to diagnose the lesion, while immunohistochemical investigations may be utilized to exclude the histopathological differential diagnoses such as juvenile xanthogranulomas and nevi. This review also revealed total excision as the treatment of choice for BFH, with a very good prognosis and an extremely low rate of relapse.

Benign Fibrous Histiocytoma: A Rare Case Report and Literature Review

Fibrous histiocytoma is a benign soft tissue tumour that may present as a fibrous mass anywhere in the human body. The involvement of the oral cavity is extremely rare and very few cases have been reported in literature till date. We here report a case of benign fibrous histiocytoma localized in the oral cavity. The clinical and histological features of the lesion are discussed precisely in the light of a literature review of this pathology in oral cavity.

Benign fibroxanthoma of the mandible

Histiocytomas constitute a large group of tumors, the classification of which created a lot of confusion in the past. For this reason, various attempts were carried out during the last years so that a widely accepted classification system could be defined. Fibroxanthomas, according to contemporary data, are classified into benign histiocytomas and they are mostly located at the skin of extremities. They are rarely localized in the area of the head and neck, where they are found commonly in soft tissue. Fibroxanthomas located at the bones of oral and maxillofacial region are extremely rare. The purpose of this paper is to present a case of a fibroxanthoma located at the mandible as well as to analyze the histological findings of the lesion on which the diagnosis and differential diagnosis were based.

A rare case of fibrous histiocytic tumor of the tongue

Fibrous histiocytoma is a benign soft tissue tumor composed of a mixture of fibroblastic and histiocytic cells arising as a fibrous mass everywhere in the human body. Based on location it is divided into cutaneous type and those involving the deeper tissues. Involvement of the oral cavity is rare. It is important to distinguish this tumor from the more aggressive forms of fibrohistiocytic neoplasm including dermatofibrosarcoma protuberans and malignant fibrous histiocytoma (FH) (7).The clinical and histiological diagnosis, treatment, and prognosis of FH have been discussed.

A case of dermatofibroma of the upper lip

Dermatofibroma (DF) is a common benign mesenchymal tumor composed of fibroblastic and histiocytic cells. It occurs anywhere on the body surface but has a propensity for the extremities. To our knowledge, DF arising in the oral cavity, especially on the lip, is quite rare. DFs of the head and neck region have been known to be most often of the cellular type and frequently recur, so a wider initial excision is recommended. Herein we report a case of DF in a 41-year-old female who presented with a deep-seated nodule on her upper lip.

Benign fibrous histiocytoma of the buccal mucosa: case report and literature review

Benign fibrous histiocytoma is an interesting and challenging entity even in its most usual, cutaneous presentation. Noncutaneous presentation is extremely limited, even more so for the mucosa of the head and neck area. We herein report such a case, describing the clinical characteristics of the lesion, complete diagnostic evaluation, management, and follow-up. Diagnostic histopathological challenges are specifically illustrated. A complete review of the relevant literature is also included.

Oral benign fibrous histiocytoma: two case reports

Fibrous histiocytoma is a benign soft tissue tumour arising as a fibrous mass everywhere in the human body. The involvement of the oral cavity is rare. We report two cases of benign fibrous histiocytoma that localized in the oral cavity. The clinical and histological features of the lesion are reported. Finally, a literature revision of this pathology at the level of the oral cavity is reported.

Benign fibrous histiocytoma (BHF) of the cheek: CD 68-KP1 positivity

We present a case of fibrous histiocytoma of the cheek in a 32-year-old male with no evidence of any regional invasion or distant metastasis. Pathologic analysis and diagnosis of these lesions is often challenging, and usually based on a combination of light microscopy and immunohistochemistry. In this study the diagnosis was confirmed using immunostaining with the antibody CD 68-KP1 that is positive in any lesion containing lysosomal granules or phagolysosomes.

Fibrous histiocytomas of the soft palate

Fibrous histiocytomas (FHs) of the oral cavity are exceedingly rare. We report a case of fibrous histiocytoma located in the soft palate of an 11-year-old male. A review of the English literature shows only 4 previously reported cases in this location. This report includes an overview of the clinical and histopathological features of this fibrohistiocytic disorder. A review of the current classification, as well as the diagnosis and management of these neoplasms as they pertain to the head and neck region are discussed.

Xanthomatous lesions of the mandible: osseous expression of non-X histiocytosis and benign fibrous histiocytoma

Seven cases of xanthomatous lesions of the mandible, followed from 1 to 18 years, are documented. All lesions were benign and painless; radiographic appearances varied from single and well-demarcated to diffuse and multilocular. Microscopic examination showed sheets of histiocytes with xanthoma or foam cells, fibroblasts and fibrous tissue, and inflammatory cells as well as cells in transition, with characteristics of both histiocytes and fibroblasts. Immunohistochemical staining and electron microscopic observation provided further evidence of the biphasic nature of this cell population. Twelve similar cases were found in the literature under a variety of diagnostic or descriptive labels. Our findings show that these lesions are histiocytic in nature and that they range from small, innocuous lesions, which we regard as the osseous counterpart of non-X histiocytosis, to larger, more destructive lesions diagnosed as benign fibrous histiocytoma (fibrous xanthoma) of bone.

Xanthofibroma of the mandible

A review of the literature reveals very few lesions within bone which appear to be xanthofibromas (fibrous histiocytomas) similar to those found in the soft tissues without other associated lesions. These are even more rare within the jaw bones. This case is presented to document such a lesion.

Malignant fibrous histiocytoma of the tongue

Malignant fibrous histiocytoma (MFH) can occur as a rare mesenchymal neoplasm of the deep structures of the head and neck region. An unusual case of MFH of the tongue is described in a 61-year-old male. The primary tumour measured 90 X 50 X 30 mm. Treatment consisted of hemiglossectomy in continuity with a supra-omohyoidal neck dissection. The patient has been free from disease for 2 years. The tongue as a primary site of MFH has not been reported to date. The literature of oral manifestations and treatment of this neoplasm 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.