Benign fibrous histiocytoma of bone

Benign fibrous histiocytoma is closely related to fibroxanthoma of bone, is a rare lesion usually occurring in the skin where it is known as dermatofibroma.

Typically presents with pain, and most often in the third decade.

Only a few case reports have been published but locations these have occurred include:

  • ribs
  • pelvis: including the sacrum and ilium
  • tubular bones: epiphysis or diaphysis
  • commonly seen around the knee
Plain film and CT
  • lytic, loculated, with prominent sclerotic border
  • narrow zone of transition
  • no matrix mineralisation
  • cortical expansion and soft tissue invasion are rarely seen
MRI
  • T1
    • central low signal intensity
    • peripheral enhancement
  • T2
    • heterogeneous high signal intensity
    • low signal in surrounding sclerotic bone
Bone scan
  • may be positive

Surgical resection. Local recurrence is ~15% (range 5-25%).

  • non-ossifying fibroma
    • younger patients
    • usually no pain
    • more prominent marginal sclerosis
    • no uptake on bone scan 3
Bone tumours

The differential diagnosis for bone tumours is dependent on the age of the patient, with a very different set of differentials for the paediatric patient.

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Article Information

rID: 5427
Section: Pathology
Synonyms or Alternate Spellings:
  • Benign fibrous histiocytoma

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