Hemosiderotic fibrohistiocytic lipomatous lesion: case report and review of the literature

Abstract

We describe the case of a 33-year-old female patient with a soft-tissue lesion in her left knee that was diagnosed as a hemosiderotic fibrohistiocytic lipomatous lesion. This type of lesion, which was described for the first time in 2000, preferentially affects the ankle region of middle-aged women with a history of previous local trauma. Lesion recurrence is common, caused by incomplete resection, although there have not yet been any reports of metastases. After a review of the literature, we describe the clinical, radiological, morphological and immunohistochemical characteristics, along with their main differential diagnoses.

Report of an Unusual Case of Hemosiderotic Fibrohistiocytic Lipomatous Tumor with Systematic Review of Clinicopathological Characteristics and Differential Diagnosis

“…Luzar et al [9] 2006 1 Female 47 Ankle 1.9x1.2 cm West et al [10] 2007 1 Female 38 Foot NA de Vreeze et al [11] 2008 1 Male 66 Thigh 19x8x4 cm Wettach et al [12] 2008 1 Female 35 Foot NA Hallor et al [13] 2008 1 Female 40 Ankle NA Ramalho et al [14] 2009 1 Female 33 Knee 10x8x6 cm Moretti et al [15] 2010 1 Female 56 Foot 7x5x2 cm Antonescu et al [2] 2011 14 2 -Male 12 -Female 45 13 -Foot 1 -Hand NA Sawalha Setal. [3] 2011 1 Female 55 Hand 3x1 cm Carter et al [4] 2014 Marusic Z et al [16] 2014 1 Female 57 Ankle 15x5 cm Zreik et al [17] 2016 1 Female 77 Foot NA Morency et al [18] 2016 1 Female 55 Foot 3x1 cm Wilk et al [19] 2016 1 Female 45 Foot 14x6 cm Etchebehere et al [20] 2016 1 Female 38 Thigh 22x18x11cm Hou et al [21] 2018 1 Male 50 Knee joint 4x2.5x1.9cm Bourhroum N et al [22] 2019 1 Female 50 Ankle 7 cm Pang CY et al [6] 2021 and Fanburg -Smith.…”

Sarcomatous transformation of a hemosiderotic fibrohistiocytic lipomatous tumor: a case report

“…Previous authors have concluded that HFLT, PHAT, and MIFS represent morphologic variants of a single entity, in which only the later has acquired the capacity to metastasize 3, 8, 9. One histological study suggested that most, if not all, tumors diagnosed as PHATs might actually represent examples of MIFS with aberrant angiectatic hyalinized vessels.…”

“…Herein, we report a published case of a lesion that had previously been diagnosed, according to its morphological and by immunohistochemical (IHC) features, as HFLT 8 . The lesion recurred twice and later showed malignant transformation to a low-grade unclassified pleomorphic sarcoma, with an IHC study suggesting myofibroblastic differentiation.…”

“…Clinical and pathological features of HFLT are similar to those of pleomorphic hyalinizing angiectatic tumor (PHAT) and myxoinflammatory fibroblastic malignant tumor (MIFS), leading authors to speculate that HFLT may be a part of a spectrum involving these two other tumor types 8, 9, 10. HFLT does not produce metastases and is of uncertain lineage according to the soft-tissue tumor classification system of the World Health Organization 1 …”