Benign Fibrous Histiocytoma of Sacroiliac Joint

* Korhan Ozkan, Kerem Bilsel, Harzem Ozger,  Feyza Unlu Ozkan, Zafer Coban

*Medical Faculty of Istanbul University, Department of Orthopedics and Traumatology, Istanbul, Turkey
 

Address for Correspondence

Korhan Ozkan, MD,
Istanbul Universitesi Ortopedi ve Travmatoloji A.B.D, ISTANBUL/TURKEY
Tel: +90 (212) 414 20 00 ( 3 2875)
Fax: +90 (216) 473 50 08
Cell Phone: +90 (532) 224 24 48
E-mail: feyzamd@yahoo.com, korhanozkan@hotmail.com

Abstract

Benign fibrous histiocytoma of bone is an extremely rare tumor with fibroblastic andhistiocytic differentiation.¹ It is usually seen between third and sixth decades of life. ² The most presenting symptom is pain. ³ The tumor usually has a well defined radiolucent zone, with a soap bubble appearance and sclerotic rim and no periosteal reaction.¹
Key words: sacroiliac joint, pain, histiocyte ,benign

J.Orthopaedics 2006;3(1)e9

Case Report:

A 65 years old woman was seen after having had pain in her right pelvis for more than a one year. The physical examination revealed no findings. Plain radiographs displayed a well circumscribed lucent lesion with sclerotic rim in her sacroiliac joint (figure 1). MRI displayed a well circumscribed lesion (figure 2). An open biopsy was performed and pathological specimens showed proliferation of fibroblasts as benign oval spindle cells mixed with mononucleated and multinucleated histiocytes. Macroscopic yellow zones of tumor was found to be composed of variable amount of large round cells with vacuolated cytoplasm. No pleomorphism and atypical mitosis was detected. Following open biopsy one month later, intralesional curettage followed by spongious chips greft insertion was performed. Patient’s symptoms disappeared completely 1 week after operation and started to walk with full weight bearing two weeks after. One year later the patient was alive with no evidence of disease.

Discussion :

It is impossible to differentiate benign fibrous histiocytoma from metaphyseal fibrous defect on the basis of histologic and electron microscopic findings. Metaphyseal fibrous defects are usually seen in children between the ages of four and eight while benign fibrous histiocytoma is seen between third and sixth decades .Metaphyseal fibrous defects are located in long tubular bones metaphyseal region whereas benign fibrous histiocytoma can be located in vertebrae, pelvis, ribs other than metapyseal regions of long bones. Pain is the major symptom of benign fibrous histiocytomas and these lesions can be cured effectively with curettage and grafting.

Reference :

1. Clarke BE, Xipel JM, Thomas DP. Benign fibrous histiocytoma of bone. Am J Surg Pathol 1985;9:806-15

2. Dorfman HD, Czerniak B. Bone Tumors .St Louis, Missouri:The Mosby Company, 1998:493-513

3. Bertoni F, Calderoni P, Bacchini P. Benign fibrous histiocytoma of bone. J Bone Joint Surg Am 1986;68:1225-30.

This is a peer reviewed paper 

Please cite as : Korhan Ozkan: Benign Fibrous Histiocytoma of Sacroiliac Joint

J.Orthopaedics 2006;3(1)e9

URL: http://www.jortho.org/2006/3/1/e9

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