Benign fibrous histiocytoma of bone in a paediatric population: a report of 6 cases

Abstract

Case records and radiological investigations of six children with benign fibrous histiocytoma were studied retrospectively. BFH occurred in the femur (n = 2), tibia (n = 2) and fibula (n = 2). Clinically, patients reported pain from the lesion lasting several months (mean 6 months). The pain was not associated with pathological fracture in any patient. On X-rays, the lesions appeared as lytic and sharply demarcated with a sclerotic rim and fine trabeculations. The reported cases were located in the metaphysis and the diaphysis of the long bones. The tumour was restricted to bone, without periosteal or soft tissue reaction. Treatment consisted of careful intralesional curettage of the lesion; the defect was thereafter filled with bone bank graft or injectable phosphocalcic cement. The length of follow-up ranged from 24 months to 4.75 years (mean 35.2 months). One case presented with recurrence of the disease and required successful repeat intralesional curettage. Benign fibrous histiocytoma is probably underestimated among patients less than 20 years of age. This diagnosis should be considered in any child or teenager who presents with a non-ossifying fibroma accompanied by unexplainable pain or a rapid growing. Surgery restricted to the osteolytic lesion seems sufficient to achieve bone healing.

Non-ossifying fibromas: Case series, including in uncommon upper extremity sites

“…BFHs tend to occur in adults, while the vast majority of cases of NOF occur in children. However, it has been proposed that BFHs may be underestimated among patients less than 20 years of age, and the diagnosis of BFH should be considered when NOF-like pathology is accompanied by pain or rapid lesion growth[7]. In the current series, NOFs in the lower extremities ossified, even in cases with large lesions that increased in size, but none was diagnosed as BFH.…”

“…Cytological abnormalities of translocation (1;4)(p31;q34) and del(4)(p14) supplied evidence for some NOFs with neoplastic characteristics[5,6]. It is possible that NOFs could have a neoplastic nature because histologically they are indistinguishable from the neoplastic lesions of BFH, which are more aggressive in nature than those of NOFs[7]. Using image analysis techniques to differentiate between BFHs and NOFs, BFHs appear more likely to have less distinct borders that are central rather than eccentric[7,8].…”

“…It is possible that NOFs could have a neoplastic nature because histologically they are indistinguishable from the neoplastic lesions of BFH, which are more aggressive in nature than those of NOFs[7]. Using image analysis techniques to differentiate between BFHs and NOFs, BFHs appear more likely to have less distinct borders that are central rather than eccentric[7,8]. BFHs tend to occur in adults, while the vast majority of cases of NOF occur in children.…”

Intraspinal extradural benign fibrous histiocytoma of the lumbar spine in a pediatric patient. Case report and literature review

“…The patients reported pain for several months (mean 6 months). Curettage restricted to the osteolytic area is sufficient to prevent recurrence [16]. Bone grafting could be considered to improve bone healing.…”

A Patient with Fixed Flexion Deformity of Hip and Knee

“…Although it may present in much earlier stage of life even in first year. 6 Benign fibrous histiocytoma is radiologically seen as well-defined lytic expanding lesion with little periosteal reaction. In contrast to non-ossifying fibroma this lesion is considered as true neoplasm.…”