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.
Clinical presentation
Typically presents with pain, and most often in the third decade.
Pathology
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
Radiographic features
Plain film and CT
- lytic, loculated, with prominent sclerotic border
- narrow zone of transition
- no matrix mineralization
- 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
Treatment and prognosis
Surgical resection. Local recurrence is ~15% (range 5-25%).
Differential diagnoses
- non-ossifying fibroma
- younger patients
- usually no pain
- more prominent marginal sclerosis
- no uptake on bone scan
Siehe auch:
