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.

Giant cell tumor of bone in an eighteenth-century Italian mummy

Giant cell tumor (GCT) of the bone is a locally aggressive and rarely metastasizing neoplasm. It is composed of neoplastic mononuclear stromal cells with a monotonous appearance admixed with macrophages and osteoclast-like giant cells. In a small subset of cases, GCT is malignant. Terminology previously related to this entity, and which is no longer supported by the World Health Organization, includes osteoclastoma and benign fibrous histiocytoma (BFH). Giant cells occur in numerous other pathologic conditions of the bone, which accounts for the misrepresentation of these non-GCT tumors in the early literature. Non-ossifying fibroma (NOF), aneurysmal bone cyst, and chondroblastoma have been erroneously labeled GCT for this reason. A single description of an ancient GCT was reported by Brothwell and Sandison and subsequently mentioned by Aufderheide and Rodrìguez-Martìn who were astonished that more of these tumors had not been identified in archaeological cases. To the best of our knowledge, no other cases of ancient GCT have been cited in the paleopathology literature. The study of this type of neoplasm in antiquity can be used as a means to better understand its characteristics and behavior and to expand the depth of time of the etiology of these lesions. We report a case of GCT of the left femur observed following the total body CT imaging of a partially mummified adult female, dating to eighteenth century.

Conjunctival and Corneal Fibrous Histiocytoma: Brief review

Background: Fibrous histiocytoma (FH), a mesenchymal tumour, usually have an orbital presentation. Rarely, FH in both benign and malignant forms have been reported at limbus and conjunctiva. Present narrative review was conducted to determine demographic profile, clinical presentation and management options for this rare tumour.Methods: PubMed database was searched to identify articles presenting with fibrous histiocytoma of conjunctiva, cornea and limbus. Data was tabulated for age of presentation, sex, eye involved, area of involvement, if tumor was benign or malignant, management and recurrences.Results: Total of 35 articles were selected, which included 42 cases, of which 27 were benign and 15 malignant. 25 cases showed presence of limbal FH, 12 conjunctival, 4 caruncular and 1 corneal FH. Mean age of presentation was 30.9 years with male preponderance (females-10, males-17) in benign FH while malignant FH presented with mean age of 44.5 years and sex distribution of 7 females and 8 males. 4 cases of benign FH showed recurrence, which required re-excision and immunotherapy, while recurrence in malignant FH was 60%, where 4 needed exenteration, 3 enucleation and 1 expired due to metastasis.Conclusion: FH is one of the rare ocular tumours of eye presenting usually at the limbus and conjunctiva and rarely cornea. Histopathological examination along with immunostaining has a definite role in the diagnosis. Surgical excision with tumour free margins is the corner stone of treatment. Recurrences in benign varieties need re-excision or immunotherapy, while malignant cases need aggressive surgical options like exenteration or enucleation.

Benign fibrous histiocytoma of the maxilla: A rare case report and literature review

Benign fibrous histiocytoma (FH) is a benign soft-tissue tumor that can present as a fibrous tissue mass anywhere in the body. The involvement of the paranasal sinuses is extremely rare, and very few cases have been reported in literature till date. We here report a case of benign FH localized in the maxillary sinus. The clinical and histological features of the lesion are discussed with a brief literature review of this pathology in the paranasal sinuses.

A Clinicohistopathological Analysis of Cutaneous Fibrous Histiocytomas of the Finger

Background:

Cutaneous fibrous histiocytoma (CFH) is a common, benign skin tumor predominantly occurring on the extremities or trunk. However, CFH on the finger is rare.

Objective:

This study was undertaken to examine the clinicohistopathological features of CFH of the finger.

Materials and Methods:

This is a retrospective study of 12 CFHs located on fingers in a tertiary hospital in Korea. All case slides were retrieved from saved files.

Results:

Ages of the CHF of the finger affected individuals ranged from 9 to 48 years with a male-to-female ratio of 1.4:1. Picker's nodule or wart was the most common clinical diagnosis. In only 2 out of the 12 cases was the pre-biopsy diagnosis of CFH ventured. Fibrocollagenous type was the most common histological type. Majority of the cases were mitotically inactive, exhibiting only 0–1 mitoses per high-power field and there was no recurrence. Tumor cells were uniformly CD34 negative.

Conclusion:

Because CFH can resemble malignancies including dermatofibrosarcoma protuberans, a lack of familiarity with the occurrence of CFH of the finger may lead to more aggressive treatment. Dermatologists should include CFH in their differential diagnosis of circumscribed nodules on the fingers to ensure proper management.

A rare presentation of benign fibrous histiocytoma in the maxilla

Fibrous histiocytoma is a soft-tissue tumor that may present as a fibrous mass anywhere in the human body. The involvement of the oral cavity is rare. We here report a case of benign fibrous histiocytoma localized in the maxilla. A 25-year-old male presented with a slowly increasing large painless mass over the left side of the upper jaw for 5 months. The swelling was of gradual onset, slowly progressive and was not associated with pain, tenderness, or discharge. The radiographic appearance showed a multilocular mixed radiodense, radiolucent lesion in the left posterior maxilla. The histopathological report showed connective tissue component having streaming fascicles of spindle-shaped cells showing a storiform pattern. Many areas showed foamy histiocytes along with few multinucleated giant cells. The cells were appearing benign without any appearance of atypia. The tumor cells were positive for CD-68 and vimentin and negative for CD-34 and S100. The lesion was excised under general anesthesia.

Benign fibrous histiocytoma of the lower lip

The fibrous histiocytoma is a soft-tissue neoplasm of the biphasic cell population of fibroblasts and histiocytes that affects the dermis and the subcutaneous tissue. The objective of this article is to report a case of benign fibrous histiocytoma (BFH) of the lower lip in a 32-year-old female patient with a chief complaint of swelling in the lower lip for the past 1 month. With diagnostic clinical hypothesis of fibrous hyperplasia, fibrous histiocytoma and mucocele, an excisional biopsy was performed. The histopathological examination revealed a nonencapsulated proliferation of spindle cells with some giant multinucleated cells in the periphery of the lesion. Multinucleated giant cells and lymphocytes were noted throughout the lesion. Immunohistochemical reactions were performed, staining only CD68 in the multinucleated giant cells. According to these characteristics, the final diagnosis was BFH.

The first total vertebral involvement of benign fibrous histiocytoma: A case report and literature review

BACKGROUND

Benign fibrous histiocytoma (BFH) is a rare bone tumor, extremely seldom in the spine.

METHODS

We present a 52-year-old patient diagnosed with a BFH in the thoracic spine treated with total en bloc spondylectomy. A review of the published literature was also conducted.

RESULTS

Non-ossifying fibroma (NOF) and BFH are named as one tumor called NOF/BFH. A total of 20 spinal BFHs have been previously reported, mainly involving the posterior elements. We present a BFH with total vertebral involvement. Curettage and excision are the main treatment options with limited recurrence.

CONCLUSIONS

This is the first total vertebral BFH up to now. Spinal BFH occupies rather low aggressiveness. With rather limited recurrence and malignant degeneration, surgical interventions seem enough for its management.

Primary Intraosseous Xanthomas of the Jaws: A Series of Six Cases Including an Example with Formation of Apoptosis-Related Hyaline Globules, So-Called "Thanatosomes"

Primary intraosseous xanthomas of the jaws (PIXJ) are rare and predominantly affect the posterior mandible (86%) of normolipemic patients, with a mean age of 30 years and no gender predilection. Clinically, PIXJ exhibit indolent biologic behavior; curettage is considered treatment of choice. Only 36 PIXJ have been reported. Apoptosis-related hyaline globules (HGs), also known as "thanatosomes", have not been previously reported in PIXJ. Cases diagnosed as xanthoma of bone were retrieved. Six cases fulfilling currently accepted criteria were identified and their clinicopathologic and immunohistochemical properties are presented herein. Mean age for PIXJ was 21.8 years (range = 12-33) and F:M ratio = 2:1. All cases presented as well-demarcated, unilocular or multilocular radiolucencies. Microscopically, PIXJ featured sheets of lipid-laden macrophages with eosinophilic or foamy cytoplasm. A secondary fibroblastic population lacking storiform pattern was evident in two cases. Adipocytes (3/6), peripheral neurovascular bundles (1/6), bone fragments (3/6) and dystrophic calcifications (3/6) were observed enclosed by the xanthoma cells. Notably, one case exhibited numerous, spherical, eosinophilic HGs containing apoptotic nuclei. PIXJ were consistently CD68(+) and negative for CD1α and S100. CD45 decorated lymphocytes and the membrane of foamy histiocytes. Xanthoma cells stained for lysozyme and plasma proteins including alpha-1 antitrypsin (AAT), IgG and IgA in one probed case. HGs were lysozyme(+), AAT(+), IgG(+), IgA(+), PAS(+) and diastase-resistant, and fuchsinophilic with Masson's trichrome. PIXJ represent infrequent, solitary, mandibular lesions with a predilection for the second and third decade of life. Thanatosomes associated with cell injury and death can be present in PIXJ.

A rare case of benign fibrous histiocytoma of the cornea

Fibrous histiocytoma (FH) commonly occurs in the superficial layers of the skin. Orbit and limbus are documented ophthalmic sites of involvement but isolated corneal FH has never been reported in literature. We present the first case of FH exclusively involving the cornea where a 10-year-old male child presented with a 3-month history of a painless growth on the superior cornea of the right eye with deterioration of vision. Tumor excision with therapeutic penetrating keratoplasty was done and the histopathological examination confirmed the diagnosis. There was no recurrence and the corneal graft was clear at 1 year.

A huge benign fibrous histiocytoma arising from the renal capsule: report of a case

Background

Neoplasms originating in the renal capsule are very rare. Benign fibrous histiocytoma(BFH) most commonly occurs in the dermis and subcutis, few cases of this tumor appear in the renal capsule. In particular, BFH larger than 20 cm are scarce. Here we report a rare huge one measuring 23 × 13 × 7 cm.

Case presentation

We report a 64-year-old man who presented with a few-months history of dull pain in the right groin. The tumor had its point of origin in the renal capsule which is a rare condition. Histologically, the tumor was composed of intersecting fascicles of fibroblastic cells forming a “storiform” pattern. Immunohistochemical studies were also performed, ultimately leading to the diagnosis of BFH. The patient was treated with radical nephrectomy. No recurrence was detected 4 months after surgery.

Conclusions

BFH arising from the renal capsule was very rare. In particular, the case of more than twenty centimeters is extremely rare. The clinical presentation of renal BFH might be only a mass. However, differential diagnosis from renal cell carcinoma proved to be impossible before surgical intervention. It is difficult to diagnose only by means of histopathology, but the immunohistochemical method can provide a clear and definite diagnosis.

Application of 3D-printed PEEK scapula prosthesis in the treatment of scapular benign fibrous histiocytoma: A case report

•

This was the first study to use PEEK scapula material prepared by 3D printing technology.

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The 3D-printed PEEK scapula prosthesis offers precise reconstruction.

•

The 3D-printed PEEK scapula prosthesis is beneficial for early functional recovery.

Background

Bone benign fibrous histiocytoma (BFH) is an invasive primary bone tumor. When the local excision is not complete, the risk of recurrence is high, and hence, one-piece resection is necessary. The major challenge for clinicians is to reconstruct the bone after resection of the tumor. The present study investigated the efficacy of 3-dimensional (3D) printing technique in the treatment of benign fibrous histiocytoma of the scapula.

Methods

The patient with benign fibrous histiocytoma of scapular bone was treated with PEEK (polyetheretherketone) prosthesis replacement using the 3D printing technique. X-ray and computed tomography (CT) scans evaluated the relationship between the position of the prosthesis and that of the shoulder joint. Also, the constant score of the shoulder joint was calculated.

Results

The anteroposterior radiograph showed that the position of the left scapula prosthesis is satisfactory and that of the shoulder joint is normal. Three months after the operation, the X-ray examination indicated the lack of flexibility and shift, as well as, dislocation and disjunction of PEEK prosthesis. The constant score of the left shoulder function was 68 points. Active shoulder joint activity: 120° on the lift, 90° on abduction, 50° on the external rotation, and 70° on internal rotation.

Conclusions

The application of 3D-printed PEEK scapula prosthesis with total shoulder replacement offers the possibility of accurate reconstruction, improves the operability of surgery, shortens the operation time, and allows early functional recovery of the patients.

Microphthalmia-associated transcription factor (MiTF): Promiscuous staining patterns in fibrohistiocytic lesions is a potential pitfall

Microphthalmia-associated transcription factor (MiTF) is used as a marker of melanocytic differentiation. However, MiTF immunoexpression has also been observed in histiocytes, macrophages, smooth muscle cells and fibroblasts, which raise the concern of fibrohistiocytic (FH) lesions being misdiagnosed as melanoma based on MiTF immunoreactivity. MiTF has been known to be positive in FH tumors, but this is the first study evaluating ninety-three fibrohistiocytic neoplasms to understand and delineate the staining pattern of MiTF in these tumors. Ninety-three cases of FH, 30 cases of melanocytic lesions, and 20 miscellaneous cases were studied. The FH cases included benign fibrous histiocytoma (BFH, n = 29), angiofibroma (AF, n = 11), fibromatosis (FM, n = 14), keloid (KE, n = 10), atypical fibroxanthoma (AFX, n = 7), dermal scar (DS, n = 9), dermatofibrosarcoma protuberans (DFSP, n = 12), and pigmented DFSP (Bednar tumor, n = 1). Benign fibrous histiocytoma were sub-categorized into dermatofibroma (n = 15) and epithelioid fibrous histiocytoma (n = 14). The melanocytic lesions included desmoplastic melanoma (DM, n = 8), melanoma in-situ (MIS, n = 5), re-excision-free of melanoma (RFM, n = 10), blue nevus (BN, n = 5), and spitz nevus (SN, n = 3). The miscellaneous category included osteosarcoma (OS, n = 3), pigmented basal cell carcinoma (PBCC, n = 5), spindle cell squamous cell carcinoma (SCA, n = 2), and giant cell tumor of tendon sheath (GCTTS, n = 10). All BFH, AF, AFX, KE, and DS cases showed a positive MiTF staining of variable extent and intensity. MiTF positivity was observed in 86% (n = 12) cases of FM and 17% (n = 2) cases of DFSP. Amongst the miscellaneous category, all cases of PBCC and GCTTS and 50% (n = 1) cases of SCA were immunoreactive for MiTF. All melanocytic lesions were positive for MiTF. None of the OS and pigmented DFSP showed positive labeling. Because of the promiscuity of MiTF labeling, awareness of its pattern in FH proliferations may avoid potential pitfalls in the diagnosis of spindle cell lesions.

Dermatofibroma: sonographic findings and pathologic correlation

Background Ultrasound has been increasingly used for the evaluation of superficial soft tissue lesions. Dermatofibroma is one of the most common dermal lesions. Experiences in ultrasound examinations of dermatofibromas have been accumulated. Purpose To evaluate sonographic findings of dermatofibroma and to correlate them with pathologic findings. Material and Methods A total of 18 dermatofibromas in 15 patients were included. Sonographic findings were assessed for location, depth, size, shape, margin, spiculation, echogenicity, internal hyperechoic dots, change in echogenicity of adjacent soft tissue, and vascularity, by two musculoskeletal radiologists in consensus. Pathologic findings were evaluated by one pathologist. Ultrasonographic characteristics were correlated with the pathologic findings by discussion between one radiologist and one pathologist. Results On ultrasound, all lesions were found to be located in the dermis, and 14 lesions (78%) extended into the subcutaneous layer. Mean size was 7 mm (range = 3 to 10 mm). Characteristic findings were ill-defined margins (n = 15, 83%), spiculated margins (n = 12, 67%), change in echogenicity of adjacent soft tissue (n = 14, 78%), and no Doppler flow (n = 14, 78%). Histologically, depth, margin, and spiculation were correlated with sonographic findings. Reactive fibrosis and chronic inflammation were seen in adjacent dermis and subcutaneous fat layer of echogenicity change. Conclusion On ultrasound, dermatofibromas are usually visible as avascular dermal lesions with extension into the subcutaneous layer, and are characterized by ill-defined margins, marginal spiculation, and change in echogenicity of surrounding soft tissues.

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

Fibrous histiocytoma is a benign tumor of mesenchymal origin. The tumor frequently appears in sun exposed areas on skin and orbital tissues. The subcutaneous appearance of this tumor in deep soft tissues is rare. We present here the eighth reported case of subcutaneous benign fibrohistiocytoma in a 27 year old male patient. Histopathology of the tumor comprises fibroblastic and histiocytic cells which mimic dermatofibroma, xanthomas and nodular fasciitis. Special stains like vimentin can only differentiate these tumors.

Benign Spindle Cell Tumour of Mandible and Points of Modification in Reconstruction with Nonvascularised Iliac Crest Graft

Benign fibrous histiocytoma (BFH) is a rare spindle cell tumor occurring in the jaw. It is a benign lesion composed of spindle shaped fibroblasts arranged in a storiform pattern. Literature shows that there are less than hundred reported cases of BFH worldwide and only six reported cases in the mandible. In this article, we are reporting a rare case of BFH in mandible and novel points of modification in reconstruction with nonvascularised iliac crest graft .

A Tete - a - tete of benign, borderline and malignant fibrohistiocytic tumor

Dermatofibrosarcoma protruberans is a relatively uncommon slow growing, locally aggressive fibrous tumor of the skin. It has a prospensity of progressing to fibrosarcomatous change in 5% of the cases. We present a case of a 56 yr old male with presented to the outpatient department of surgery, Sri Siddhartha Medical College, Tumkur with a chest swelling in 2013. FNAC was inconclusive and the mass was excised. On histopathology, areas of benign fibrohistiocytic tumor, dermatofibrosarcoma protruberans and fibrosarcomatous dermatofibrosarcoma were identified in the same tumor. Immunohistochemistry confirmed the diagnosis of DFSP with fibrosarcomatous change. Although, transformed DFSP is more aggressive, the prognosis is influenced by the extent of excision and with wide excision, there may be little increased risk for recurrence and metastasis over that of conventional DFSP.

Benign fibrous histiocytoma arising at the temporal bone of an infant--case report and review of the literature

PURPOSE

We report a very rare case of a fast-growing benign fibrous histiocytoma at the temporal bone.

METHODS

A 1-year-old girl was referred for investigation of a right temporal mass that increased during 2-week observation. Imaging studies showed a lytic, loculated skull tumor at the left temporal bone. On magnetic resonance imaging scans, the tumor was isointense on T1- and relatively high-intense on T2-weighted images. The tumor was mostly homogeneously enhanced by gadolinium. On diffusion-weighted images, it was iso- to relatively low-intense; perfusion-weighted images revealed low perfusion.

RESULTS

Complete macroscopic resection of the tumor was performed. Immunohistochemical analysis showed that the tumor was positive for CD68 and α-smooth muscle actin and negative for CD1a and CD34; the MIB-1 labeling index was 4 %. A diagnosis of primary benign fibrous histiocytoma of the skull was made. At 6-month follow-up, there were no clinical or radiological signs of tumor recurrence and/or metastasis.

CONCLUSIONS

We review the clinical, radiological, and immunohistochemical characteristics of benign fibrous histiocytoma at the skull.

Benign fibrous histiocytoma: A rare case involving jaw bone

Benign fibrous histiocytoma (BFH) is a soft tissue neoplasm which occurs mostly on the skin of extremities. BFH rarely occurs in bone and may affect femur, tibia, and pelvic bone. Jaw bone involvement is very unusual with only 11 cases reported till date. This report describes a case of BFH occurring in a 30-year-old female patient affecting left mandibular posterior region. Computed tomography revealed a well-defined expansile lytic lesion in the posterior mandible. Gross examination of the tumor revealed an admixture of fibroblasts and histiocytes in a fascicular and storiform pattern. Immunohistochemical staining was positive for CD68.

Benign fibrous histiocytoma of the fronto-temporo-parietal region: a case report and review of the literature

Primary benign fibrous histiocytoma (BFH) at the skull is extremely rare. Here we report a case of a 22-year-old man presented with a 1-year history of progressive enlargement subcutaneous mass on the right side of the fronto-temporo-parietal region without symptoms. The tumor was radical resected through craniotomy and the bone defect was repaired by pre-plasticity titanium mesh. Histopathologic examination confirmed a benign fibrous histiocytoma, and no signs of tumor recurrence were detected at 3-year follow-up.

Signet Ring Dermatofibroma, a Rare and Confusing Variant

Dermatofibroma is a common cutaneous benign fibrohistiocytic tumour, which is usually diagnosed without difficulty. In this report we demonstrated a signet ring variant of dermatofibroma as a rare variant of this common neoplasm together with the possible differential diagnosis.The presence of signet cells in cutaneous neoplasm does not necessarily means malignancy. Signet ring dermatofibroma is a rare variant eliciting differential diagnostic problems which can be solved by careful histopathological examination, searching for the classic areas and the help of immunohistochemistry.

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.

Subcutaneous dermatofibroma: a rare case report with review of literature

A purely Sub-cutaneous benign fibrous histiocytoma (BFH; dermatofibroma) is rarely reported, as it is usually a dermally located mesenchymal tumour and in absence of supportive immunohistochemical (IHC) studies, it is often misdiagnosed. We are describing a case of a 19-year-old female who presented to the skin outpatient department with a painful swelling on the medial side of her thigh. Fine needle aspiration (FNA) revealed a sub-cutaneous spindle cell (mesenchymal) lesion which was corroborated on histopathology, with differentials of BFH and dermatofibrosarcoma protruberans (DFSP). BFH constitutes a diagnostic dilemma for both clinicians and pathologists, because the lesions share common clinical symptoms, radiological characteristics and histological features with many varied entities. For its subtyping and confirmation; immunohistochemical (IHC) studies were undertaken. In the present case, positivity of IHC markers, vimentin and smooth muscle actin emphatically proved that BFH arose exclusively from the subcutaneous region, with no dermal origin. Also, a negative CD34 immunostaining, along with low B-cell lymphoma 2 (Bcl-2) expression ruled out DFSP (both are strongly expressed in DFSP), MFH and other malignant mesenchymal lesions. Negative CD 68 staining ruled out giant cell lesions and their congeners. This case is worth reporting, as it not only describes a rare case presentation of BFH, but as it also highlights the importance of IHC, thus helping to comprehensively clinch the diagnosis by systematically ruling out other differentials.

Notch intracellular domain expression in various skin fibroproliferative diseases

Background

The effects of the Notch signaling pathway in fibroproliferative skin diseases have not been fully elucidated.

Objective

The aim of this study was to investigate the expression of activated Notch signaling molecules in various skin fibroproliferative diseases.

Methods

Immunohistochemical analysis of Notch intracellular domain (NICD) expression in keloid, hypertrophic scar, morphea, dermatofibroma, and normal control skin specimens was performed, and the clinical characteristics of patients with various skin fibroproliferative diseases were analyzed.

Results

NICD was highly expressed in fibroblasts of keloids and moderately to highly expressed in hypertrophic scars and dermatofibromas, whereas low or no expression was detected in the fibroblasts of normal skin specimens and morpheas. NICD was constitutively expressed in keratinocytes, endothelial cells, and immune cells in normal skin specimens.

Conclusion

NICD was significantly expressed in human fibroproliferative skin disorders, especially keloids, suggesting that an activated Notch signaling pathway is involved in the pathogenesis of skin fibrosis.

Dermatofibroma of the face: a clinicopathologic study of 20 cases

INTRODUCTION

Dermatofibroma is one of the most common benign skin tumors. It typically develops on the lower limbs between the third and fifth decade of life and is more common in women. Clinical diagnosis is often straightforward. Dermatofibromas are associated with a very low rate of local recurrence following excision.

OBJECTIVES

To describe the clinical and histologic features of dermatofibroma of the face based on our experience.

MATERIALS AND METHODS

Descriptive retrospective study of the clinicopathologic features of dermatofibromas of the face diagnosed at the dermatology department of Hospital General Universitario de Valencia between 1990 and 2012.

RESULTS

Twenty cases of dermatofibroma of the face (1.11% of all dermatofibromas diagnosed) were studied. The age at onset varied widely, from 28 to 84 years. The mean age at onset was 57.15 years and the median was 54 years. There were 11 women and 9 men. Mean follow-up was 83 months and there were no local recurrences. All the tumors were confined to the papillary and reticular dermis and the storiform pattern was the most common growth pattern observed.

CONCLUSIONS

This study of facial dermatofibromas diagnosed at our hospital over a period of 22 years suggests that the face is an uncommon site but that dermatofibromas in this location behave similarly to those occurring elsewhere on the body.

Deep penetrating benign fibrous histiocytoma of the foot associated with throbbing pain

Compared to cutaneous benign fibrous histiocytoma (BFH), deep-seated BFH is very rare and poorly recognized. Both cutaneous and deep-seated BFH are usually asymptomatic. We herein report a 25 year-old woman who presented with a painful mass in her foot that was poorly controlled by analgesics and associated with walking difficulty. After preoperative ultrasonographic evaluation, the mass was completely excised and histologic exam showed spindle cells loosely arranged in storiform architecture, with CD34^-, desmin^-, S-100^-, focal CD68⁺, vimentin⁺, smooth muscle actin⁺, and factor XIIIa⁺. The patient was diagnosed with deep-seated BFH based on the histologic, radiologic and intraoperative findings.

Malignant fibrous histiocytoma-case report

Fibrous histiocytoma is a tumor composed of a mixture of fibroblastic and histiocytic cells. These lesions most often arise on the skin, but may rarely occur in soft deep tissues. The diagnosis of FH may be clinically difficult when the lesion is located in the deep tissues, and is frequently confirmed after local excision. The most important diagnostic necessity is the separation of this tumor from aggressive forms of fibrohistiocytic neoplasms. We present a unique case of malignant fibrous histiocytoma developing in left buccal mucosa very near to the surgical margin from which a benign fibrous histiocytoma of the mandible was excised 3 years earlier in a 31 year old female. Clinical and histopathological evidence were not sufficient to establish link between these two processes. This article aims to describe the case and discuss the findings.