Benign fibrous histiocytoma of bone
Citation, DOI & article data
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:
- pelvis: including the sacrum and ilium
- tubular bones: epiphysis or diaphysis
- commonly seen around the knee
Plain film and CT
- lytic, loculated, with a prominent sclerotic border
- a narrow zone of transition
- no matrix mineralization
- cortical expansion and soft tissue invasion are rarely seen
- central low signal intensity
- peripheral enhancement
- heterogeneous high signal intensity
- low signal in surrounding sclerotic bone
- may be positive
Treatment and prognosis
Surgical resection. Local recurrence is ~15% (range 5-25%).
History and etymology
Tne benign fibrous histiocytoma was first described by David Carl Dahlin in 1978 as the atypical counterpart of malignant histiocytoma 1,6.
- 1. Matsuno T. Benign Fibrous Histiocytoma Involving the Ends of Long Bone. Skeletal Radiol. 1990;19(8):561-6. doi:10.1007/BF00241277 - Pubmed
- 2. Hamada T, Ito H, Araki Y, Fujii K, Inoue M, Ishida O. Benign Fibrous Histiocytoma of the Femur: Review of Three Cases. Skeletal Radiol. 1996;25(1):25-9. doi:10.1007/s002560050027 - Pubmed
- 3. Thomas K, Henderson-Jackson E, Caracciolo J. Test Yourself: Answer - Deep Benign Fibrous Histiocytoma. Skeletal Radiol. 2015;44(8):1151-2, 1209. doi:10.1007/s00256-015-2113-9 - Pubmed
- 4. WHO Classification of Tumours Editorial Board. WHO Classification of Tumours, 5th Edition. Soft Tissue and Bone Tumours. (2020) ISBN: 9789283245025 - IARC Publications
- 5. Niemeyer P, Ludwig K, Werner M et-al. Reconstruction of the pelvic ring using an autologous free non-vascularized fibula graft in a patient with benign fibrous histiocytoma. World J Surg Oncol.2 (1): 38. doi:10.1186/1477-7819-2-38 - Free text at pubmed - Pubmed citation
- 6. David Carl Dahlin. Bone Tumors. General Aspects and Data on 6221 Cases. (1978) ISBN: 9780398036928 - Google Books
- 7. Alden K, McCarthy E, Weber K. Xanthoma of Bone: A Report of Three Cases and Review of the Literature. Iowa Orthop J. 2008;28:58-64. PMC2603351 - Pubmed