Giant plexiform fibrohistiocytic tumor of skin

A rare case of congenital plexiform fibrohistiocytic tumor of the foot in a 4-year-old boy: case report and literature review

The plexiform fibrohistiocytic tumor (PFHT) is an infrequent soft-tissue neoplasm with uncertain biological behavior. We report a rare congenital PFHT case in a 4-year-old boy, treated with wide excision and skin grafting. After a 52-month follow-up, no recurrence, regional or distant metastases were documented. A literature review on the management of PFHTs is reported.

Plexiform fibrohistiocytic tumor on the chest of a 5-year-old child and review of the literature

Plexiform fibrohistiocytic tumor (PFT) is a rare neoplasm of mesenchymal origin that can be identified by its propensity for children and adolescents combined with a characteristic histologic arrangement of histiocytes and osteoclast-like giant cells whorled within tumor islands. A 5-year-old female presented with a raised, intermittently tender, and slowly enlarging tumor on her chest, which was histologically confirmed to be a PFT. We present this case along with a comprehensive review of PFT cases reported in the literature to describe the demographic, histologic, and rarely metastatic behavior of this entity. It is important to include PFT on the differential diagnosis of an enlarging tumor in the pediatric population.

Features of plexiform fibrohistiocytic tumor in skin punch biopsies: a retrospective study of 6 cases

Plexiform fibrohistiocytic tumor (PFHT) is a mesenchymal neoplasm of intermediate malignant potential, which typically presents as a dermal or subcutaneous nodule, and is therefore often sampled by skin punch biopsy where diagnostic features may be subtle or absent. We retrospectively analyzed a series of 6 cases of PFHT to highlight for dermatopathologists the features of PFHTs useful to distinguish it from the other entities in the differential diagnosis. On the basis of the proportion of spindled fibroblastic cells to histiocytoid nodules in the biopsy specimen, we divided PFHT into 3 histologic variants: cellular, fibrous, and mixed. The biopsies also were compared with the final resection specimens, in an attempt to determine which histologic features in the original biopsies were most helpful in establishing a diagnosis. Clinical follow-up and immunohistochemistry were performed on all cases. The cellular and mixed variants were a lesser diagnostic challenge inasmuch as the distinctive features were more easily identifiable in small punch biopsy specimens. The fibrous variant proved more difficult to diagnose. Features most helpful in the diagnosis of PFHT were biphasic appearance with small, cellular, histiocytoid aggregates and accompanying plump spindled cells in the deep dermis and subcutis. Negative staining for CD34, NK1/C3, factor XIIIa, and beta-catenin by immunohistochemistry proved useful in excluding some of its mimics.

Cutaneous fibrohistiocytic tumours - an update

The term 'fibrohistiocytic' tumour is a descriptive designation without histogenetic connotation for a group of heterogeneous lesions that share morphological features of histiocytes and fibroblasts on light microscopy. However, over the years it has become apparent that many so-called 'fibrohistiocytic' tumours are largely composed of relatively undifferentiated mesenchymal cells, but can also show areas of myofibroblastic differentiation. This review focuses on the clinical and histological features as well as differential diagnosis of so-called fibrohistiocytic tumours. Special emphasis is given to more recently described histological variants of fibrous histiocytoma, e.g. cellular, epithelioid, aneurysmal and atypical fibrous histiocytoma, to angiomatous and plexiform fibrous histocytoma (plexiform fibrohistiocytic tumour), lesions that are not true variants of fibrous histiocytomas but have erroneously been designated such, and to atypical fibroxanthoma. The literature on metastasizing fibrous histiocytoma is also reviewed.

Plexiform fibrohistiocytic tumor: a brief review

Plexiform fibrohistiocytic tumor is a rare mesenchymal neoplasm of intermediate malignancy, first reported by Enzinger and Zhang in 1988. It has a predilection for children and young adults but can occur at any age. The tumor usually involves the upper limbs as a slow-growing, painless mass. The tumor has a high local recurrence rate but metastasizes only rarely. Histologically, the tumor is characterized by poorly demarcated dermal or subcutaneous mass with multinodular plexiform growth and fibrohistiocytic cytomorphology. There are three distinct recognized growth patterns: fibrohistiocytic, fibroblastic, and mixed types. The tumor displays uniform immunoreactivity for vimentin and CD68. Ultrastructurally, the tumor cells have features of myofibroblasts and histiocyte-like cells. Complete surgical resection of the tumor, preferably with wider margins, is required to prevent local recurrence. Long-term follow-up is necessary to detect any nodal or pulmonary metastasis.

Plexiform fibrohistiocytic tumor in three children

Plexiform fibrohistiocytic tumor is a very rare fibrohistiocytic tumor of intermediate malignancy. It can occur at any age but is more prevalent in children and in young adults. Here we present the clinicopathologic findings of three girls with this tumor. The patients were 8 months, 14 months, and 7 years of age. They each presented with a solitary, nontender, subcutaneous nodule or plaque. Light microscopy and immunohistochemical study findings were compatible with plexiform fibrohistiocytic tumor. We also review the previously published cases in the English-language literature.

Plexiform fibrohistiocytic tumor of the foot

The first case of plexiform fibrohistiocytic tumor in the foot is presented in this article. The tumor developed on the dorsum of the left foot in a 14-year-old female. This tumor was originally described in 1988 by Enzinger and Zhang. Their study indicated that this tumor has a female predominance, median age of 14.5 years, 63% located in the upper extremities, 37.5% recurrence rate, and 3% metastasis rate. These tumors are very unique with a nodular pattern and a cellular component of histiocytes, fibroblasts, and multinucleated giant cells. Typically they are located within the deep dermis and subcutaneous tissue. Immunohistochemical preparations show that the tumor does not stain for S-100 protein, desmin, cytokeratin, factor VIII-related protein, or lysozyme. However, it does stain for alpha-1-antitrypsin, alpha-1-antichymotrypsin, alpha-smooth muscle-specific actin, vimentin, and CD68 antibody.