Benign fibrous histiocytoma of bone

Last revised by Dr Joachim Feger on 26 Jul 2022

Benign fibrous histiocytoma of bone is a term that has been used for a type of bone lesion considered histologically identical to non-ossifying fibroma but was distinguished on the basis that it was described in the adult population 1,2. The lesion needs to be differentiated from cutaneous or deep benign fibrous histiocytoma occurring in the skin that is also known as dermatofibroma 3.

As of the WHO classification of soft tissue and bone tumors (5th edition) the term 'benign fibrous histiocytoma of bone' is no longer recommended similar to other synonymously used terms such as ‘fibrous cortical defect’, ‘metaphyseal fibrous defect’ and instead ‘non-ossifying fibroma (NOF)‘ is preferred 4

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
  • lytic, loculated, with a prominent sclerotic border
  • a narrow zone of transition
  • no matrix mineralization
  • cortical expansion and soft tissue invasion are rarely seen
  • T1
    • central low signal intensity
    • peripheral enhancement
  • T2
    • heterogeneous high signal intensity
    • low signal in surrounding sclerotic bone
  • may be positive

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

Tne benign fibrous histiocytoma was first described by David Carl Dahlin in 1978 as the atypical counterpart of malignant histiocytoma 1,6.

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Cases and figures

  • Case 1
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  • Case 1
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  • Case 1
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  • Case 2: supraorbital ridge
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