Giant aneurysmal benign fibrous histiocytoma (dermatofibroma)

Abstract

Aneurysmal benign fibrous histiocytomas are variants of dermatofibromas. These benign blood-filled lesions can mimic malignancies due to their rapid and recurrent growth. Our patient is a 42-year-old Caucasian female with a past medical history of morbid obesity, diabetes, and hypertension, who presented with a mass on her left shoulder for 5 years' duration. The mass oozed occasionally and would appear to regress but then recur replaced with progressively larger masses. Upon inspection, the patient had a large pedunculated exophytic mass with vascularity. The mass was surgically removed under general anesthesia via wide local excision. Grossly, the excised skin was purple-tinged with an underlying fungating solid mass measuring 8.5 cm. Serial sections revealed a hemorrhagic, spongy, and granular cut surface. Histologically, the epidermis was hyperplastic, with underlying hyaline collagen bundles. The remainder of the mass was chronically inflamed and composed of spindled histiocytes, hemosiderin-laden macrophages, and blood-filled spaces lacking an endothelial lining. There was focal pleomorphism but no significant atypia. Immunohistochemical stains were strongly positive for vimentin and negative for CD31, CD34, and desmin. The overall architecture and immunophenotype are consistent with the diagnosis of aneurysmal benign fibrous histiocytoma.

Angiomatoid Fibrous Histiocytoma With ALK Expression in an Unusual Location and Age Group

“…Aneurysmal benign fibrous histiocytoma (ABFH) was an important differential considered in this case, as a tumour which occurs on the distal extremities, can clinically mimic vascular lesions and microscopically also demonstrates spindle cells with pseudovascular blood filled spaces [23]. However, ABFH usually demonstrates classic features of fibrous histiocytomas including scattered foamy and giant cells as well as peripheral collagen entrapment and overlying epidermal hyperplasia [24]. ABFHs do not typically demonstrate the same degree of surrounding fibrosis or inflammatory infiltrate as in AFH.…”

How reflectance confocal microscopy can help diagnose an enigmatic variant of dermatofibroma

“…“Giant dermatofibroma” describes lesions measuring 5 cm and above (Requena, ), only 21 cases have been described (Hueso, ) with different histological features (Liu, ; Goodman, ; Kaddu S, ; Iwata J, ). Our case of giant DF presents small nodules partially confluent in the context of a plaque that in some points is rough to the touch, and these peculiarities are not found in Literature.…”

A Giant Aneurysmal Benign Fibrous Histiocytoma with Muscle Involvement: A Rare Case Report

“…Aneurysmal BFH usually show solitary nodule measuring between 0.5 and 4 cm in the extremities 1 . The BFH larger than 5 cm is called giant BFH and the largest aneurysmal BFH reported so far is 8.5 cm mass 2 .…”

“…Mitotic activity and significant cellular atypia are rare in comparison with these aggressive diseases. 2 …”