Fatal Case of Metastatic Cellular Fibrous Histiocytoma

Abstract

Given the possible aggressive nature of cellular type of fibrous histiocytoma, we advice complete excision and clinical follow-up. Chest x-rays and ultrasound examination of regional lymph nodes should be performed in atypical lesions.

Fibrous histiocytoma/dermatofibroma in children: the same as adults?

“…While classic FH was the predominant pattern observed in our pediatric cases, our study demonstrated a similar variety of histology variants in pediatric patients to that in adult populations. A small percentage of FHs, in particular the atypical, cellular, and aneurysmal variants, have been reported to have increased risk of recurrences of up to 20% when incompletely excised [6,7,9] or, even more rarely, metastasis [15,16]. In our search, 2.9% (8/269) of patients had a clinical history of relapse, the majority of which were classified as the cellular variant; however, we also identified recurrent cases with morphology consistent with classic FH and dermatomyofibroma.…”

“…The cellular, atypical, and aneurysmal variants have been shown to have increased rates of local recurrence of around 20% in cases of incomplete excision [6,7,9]. Rare cases of metastasis of apparently histologically benign FH have also been reported [15,16].…”

Firm, protuberant plaque on a 7‐year‐old's arm

“…Although classified as benign entities, at least 38 cases of metastatic DF have been reported, with metastasis most commonly to the lungs (23 cases), lymph nodes (22 cases), and proximal soft tissue (8 cases). There have been nine reported deaths due to metastatic disease; 27 of these metastatic cases (71%) were CDF, which is a disproportionate share, especially considering the relative rarity of CDF among DF otherwise. Although these cases are troubling, DF are common.…”

Diagnosis and differential diagnosis of dermatofibrosarcoma protuberans: Utility of high‐resolution dynamic contrast‐enhanced (DCE) MRI

“…CDF is characterized by abundant spindle cells with increased mitotic activity, which may also easily recur locally after incomplete resection, 4,8 especially lesions with a size of greater than 1 cm. Although as a kind of benign tumor, some researches have reported the distant metastasis of CDF 10–13 . WLE 10 and MMS 4 could also decrease the recurrence rate of CDF.…”

“…Although as a kind of benign tumor, some researches have reported the distant metastasis of CDF. [10][11][12][13] WLE 10 and MMS 4 could also decrease the recurrence rate of CDF. To sum up, DFSP and CDF have a lot in common in recurrence, "metastasis" and resection.…”