Surgical Treatment of Benign Fibrous Histiocytoma as a Form of Intraspinal Extradural Tumor at Lumbar Spine

Abstract

A benign fibrous histiocytoma (BFH) is one of the fibrohistiocytic groups of soft-tissue tumors for which spinal involvement is extremely rare. To the best of our knowledge, most spine-originating BFHs are bone tumors. We report the first case of BFH occurring in the intraspinal extradural space on the lumbar spine. A 66-year-old female presented with severe claudication symptom. The preoperative magnetic resonance images showed a huge intraspinal, extradural, thecal-sac-compressing soft-tissue tumor that extended along the right L5 root to the neural foramen. The tumor was a relatively well-marginated, inhomogeneous soft-tissue mass with some fluid-containing cystic portions that were well enhanced by the gadolinium contrast dye. After a total facectectomy, the tumor was removed completely. The patient had a good neurological recovery without complications, and no recurrence was noted at the 6-month follow-up.

Total vertebral involvement by benign fibrous histiocytoma: A case report and literature review

“…Age of the reported spinal BFHs ranged between 6 and 66 years, with a mean age of 28.11 years. A female predominance existed in spinal BFHs (F/M: 13/6), quite different from that in the total BFHs (F/M: 1/2) [12]. Learning from the reported cases, local pain was the cardinal symptom when admission.…”

“…Benign fibrous histiocytoma (BFH) is a rare bone tumor accounting approximately 1% of all benign bone tumors, commonly located in the meta-epiphysis and diaphysis of long bones, mostly in male and adult patients [1]. Spinal involvement is rather rare: to the best of our knowledge, only 19 cases have been previously described since 1979 [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]. Among the previous reports, almost all were involved in the posterior elements such as spinous process, lamina, transverse process, while total vertebral involvement was not found.…”

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

“…Spinal involvement is very rare: to the best of our knowledge, 17 cases have been previously described since 1979 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Among the four cases involving pediatric patients [1,5,8,9], this report is the first case of tumor located in the intraspinal, extradural lumbar spine.…”

“…To the best of our knowledge, spinal localizations of BFH has been previously described in 17 cases (12 M, 5 F) [2][3][4][5][6][7][8][9][10][11][12][13][14][15], only 4 cases involved patients younger than 18 years old, 1 cervical and 3 thoracic (Table 1). Kim et al described a similar case of intraspinal extradural BFH, involving the lumbar spine [14] of a 66-year-old female.…”

Management of giant benign fibrous histiocytoma in the spinal region with pleural involvement

“…[1,2] The most prevalent sites of BFHs are the skin and eyeballs, followed by the pharynx, larynx, trachea, and lungs. [5,6] The incidence of BFH in males is approximately 2 times of that in females. [1–3,7] BFH grows slowly, recurs locally, and may metastasize later, thus it can be difficult to diagnose and may result in devastating consequences if mismanaged.…”