Deep benign fibrous histiocytoma

Case contributed by Dr Chris O'Donnell

Presentation

Slowly enlarging, non-painful swelling over the right supraorbital ridge.

Patient Data

Age: 60 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Crescentic T1 and T2 hypointense subcutaneous mass overlying the skull vault with diffuse gadolinium enhancement.

Ultrasound was used to guide percutaneous biopsy

Ultrasound

Crescentic solid mass with minor pressure erosion on the outer table of the skull.  Biopsy result is "low-grade spindle cell proliferation with immunocytochemistry (positive CD 68, positive CD 163 and positive factor XIIIa, negative EMA and SMA) suggesting benign fibrous histiocytoma"

Case Discussion

A benign fibrous histiocytoma is one of the most common mesenchymal neoplasms of the skin and is cutaneous in location. A deep benign fibrous histiocytoma is an uncommon and poorly recognized clinical subtype that arises in subcutaneous or deeper soft tissue such as in this case. They are clinically more significant as they can be associated with local recurrence post excision. Rarely they can metastasize.

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