Ann Dermatol.  2011 May;23(2):254-257. 10.5021/ad.2011.23.2.254.

Subcutaneous Dermatofibroma

• Jung KD
• Lee DY
• Lee JH
• Yang JM
• Lee ES

• KMID: 2156677
• DOI: http://doi.org/10.5021/ad.2011.23.2.254

Abstract

Dermatofibroma (DF) is usually confined to the dermis and the overlying epidermis is usually hyperplastic. Although DF with deep subcutaneous extension is commonly encountered, purely subcutaneous DF is uncommon. In this review, we describe a case of a 41-year-old male patient who presented with a painless, subcutaneous, hard papule on the left thigh. After the skin had been incised the lesion was totally removed, and histopathology revealed a subcutaneous dermatofibroma.

Keyword

Dermatofibroma; Fibrous histiocytoma; Subcutaneous

MeSH Terms

Adult
Dermis
Epidermis
Histiocytoma, Benign Fibrous
Humans
Male
Skin
Thigh

Figure

• 

  Fig. 1 Incisional biopsy specimen shows well-circumscribed, subcutaneous nodule (A: H&E, ×1). The tumor cells are arranged in storiform pattern and are trapping normal collagen bundles at the periphery of the tumor nodule (B: H&E, ×100). In higher magnification, tumor cells are cytologically bland and are spindle-shaped with variable amounts of pale eosinophilic, ill-defined cytoplasm. Nuclei are elongated and histiocyte-like with vesicular chromatin pattern. There is no nuclear pleomorphism or hyperchromasia (C: H&E, ×400).

• 

  Fig. 2 On the immunohistochemical staining, there are positive reactions for Factor XIIIa and negative reaction for CD34 and desmin in the spindle cells (A: Factor XIIIa, ×200, B: CD34, ×200, C: desmin, ×200). The CD68 staining shows negative reactions in the spindle cells (D: CD68, ×200).

Reference

1. Meister P, Konrad E, Krauss F. Fibrous histiocytoma: a histological and statistical analysis of 155 cases. Pathol Res Pract. 1978. 162:361–379.

2. Fletcher CD. Benign fibrous histiocytoma of subcutaneous and deep soft tissue: a clinicopathologic analysis of 21 cases. Am J Surg Pathol. 1990. 14:801–809.

3. Chang SE, Choi JH, Sung KJ, Moon KC, Koh JK. Subcutaneous dermatofibroma showing a depressed surface. Int J Dermatol. 2001. 40:77–78.

4. Skoulakis CE, Papadakis CE, Datseris GE, Drivas EI, Kyrmizakis DE, Bizakis JG. Subcutaneous benign fibrous histiocytoma of the cheek. Case report and review of the literature. Acta Otorhinolaryngol Ital. 2007. 27:90–93.

5. Garrido-Ruiz MC, Ramos P, Enguita AB, Rodriguez Peralto JL. Subcutaneous atypical fibrous histiocytoma. Am J Dermatopathol. 2009. 31:499–501.

6. Mentzel T, Kutzner H, Rütten A, Hügel H. Benign fibrous histiocytoma (dermatofibroma) of the face: clinicopathologic and immunohistochemical study of 34 cases associated with an aggressive clinical course. Am J Dermatopathol. 2001. 23:419–426.

7. Kamino H, Jacobson M. Dermatofibroma extending into the subcutaneous tissue. Differential diagnosis from dermatofibrosarcoma protuberans. Am J Surg Pathol. 1990. 14:1156–1164.

8. Zelger B, Sidoroff A, Stanzl U, Fritsch PO, Ofner D, Zelger B, et al. Deep penetrating dermatofibroma versus dermatofibrosarcoma protuberans. A clinicopathologic comparison. Am J Surg Pathol. 1994. 18:677–686.

9. Enzinger FM, Weiss SW. Weiss SW, Goldblum JR, editors. Malignant fibrous histiocytoma (pleomorphic undifferentiated sarcoma). Enzinger and Weiss' soft tissue tumors. 2008. 5th ed. Philadelphia: Elsevier Mosby;403–428.

10. Aiba S, Tabata N, Ishii H, Ootani H, Tagami H. Dermatofibrosarcoma protuberans is a unique fibrohistiocytic tumour expressing CD34. Br J Dermatol. 1992. 127:79–84.

11. Chen TC, Kuo T, Chan HL. Dermatofibroma is a clonal proliferative disease. J Cutan Pathol. 2000. 27:36–39.

12. Kamino H, Salcedo E. Histopathologic and immunohistochemical diagnosis of benign and malignant fibrous and fibrohistiocytic tumors of the skin. Dermatol Clin. 1999. 17:487–505.

13. Nakanishi S, Shinomiya S, Sano T, Hizawa K. Immunohistochemical observation of intracytoplasmic lysozyme in proliferative and neoplastic fibrohistiocytic lesions. Acta Pathol Jpn. 1982. 32:949–959.

14. Bisceglia M, Attino V, Bacchi CE. Metastasizing "benign" fibrous histiocytoma of the skin: a report of two additional cases and review of the literature. Adv Anat Pathol. 2006. 13:89–96.

15. Colome-Grimmer MI, Evans HL. Metastasizing cellular dermatofibroma. A report of two cases. Am J Surg Pathol. 1996. 20:1361–1367.