CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2022; 11(01): 070-072
DOI: 10.1055/s-0041-1726605
Short Communication

Benign Fibrous Histiocytoma of the Sacrum: A Rare Scenario

1   Department of Neurosurgery, Christian Medical College, Ludhiana, Punjab, India
,
1   Department of Neurosurgery, Christian Medical College, Ludhiana, Punjab, India
,
1   Department of Neurosurgery, Christian Medical College, Ludhiana, Punjab, India
› Author Affiliations

Abstract

Benign fibrous histiocytoma (BFH) of bone is quite rare, and here we report the second case of such tumor originating from sacrum, with the first being reported in an 18-year-old female. The overlapping clinical, radiological, and histopathological findings make it a difficult diagnosis along with the fact that it is a rare diagnosis. In this case report, we present the diagnostic difficulties and optimal treatment for such cases. A 46-year-old male w presented to OPD with complaint of numbness in left foot since 1 month, and intermittent urinary incontinence for 2 weeks. On examination, the straight leg raising test was positive of left side, extensor hallucis longus (EHL) was weak in both lower limbs, and bilateral ankle jerks were diminished. MRI showed well-defined lobulated solid mass lesion, which is T1 hypointense and T2 hyperintense and homogeneously involving the S1 vertebral body, with involvement of the right sacral ala, and right sacral foramen seen at S1 and S2 levels extending into the spinal canal till L4 level. Excision through a posterior midline incision was performed taking care to preserve the traversing nerves. Postoperatively, remarkable improvement in pain with no major residual neurological deficit was observed. Patient was followed-up till 9 months; patient’s incontinence improved over a period of 3 months and has stayed the same until the last follow-up.



Publication History

Article published online:
24 November 2021

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  • References

  • 1 Bertoni F, Calderoni P, Bacchini P. et al. Benign fibrous histiocytoma of bone. J Bone Joint Surg Am 1986; 68 (08) 1225-1230
  • 2 Ceroni D, Dayer R, De Coulon G, Kaelin A. Benign fibrous histiocytoma of bone in a paediatric population: a report of 6 cases. Musculoskelet Surg 2011; 95 (02) 107-114
  • 3 Dahlin DC. General aspects and data on 6,221 cases. In: Tumors Bone. 3rd ed.. Springfield: Charles C Thomas; 1978: 116-36
  • 4 Demiralp B, Kose O, Oguz E, Sanal T, Ozcan A, Sehirlioglu A. Benign fibrous histiocytoma of the lumbar vertebrae. Skeletal Radiol 2009; 38 (02) 187-191
  • 5 Fletcher CDM, McKee PH. Soft tissue tumours. In: McGee JOD, Isaacson PG, Wright NA. eds. Oxford Textbook of Pathology. New York: Oxford University Press; 1992
  • 6 Balasubramanian C, Rajaraman G, Singh CS, Baliga DK. Benign fibrous histiocytoma of the sacrum–diagnostic difficulties facing this rare bone tumor. Pediatr Neurosurg 2005; 41 (05) 253-257
  • 7 Brennan MF, Alektiar KM, Maki RG. Sarcomas of the soft tissue and bone. In: Devita VT, Hellman S, Rosenberg SA. eds. Cancer, Principles and Practice of Oncology. 6th ed.. Philadelphia: Lippincott Williams & Wilkins; 2001
  • 8 Imai Y, Yamakawa M, Sato T, Suda A. Malignant fibrous histiocytoma: similarities to the “fibrohistiocytoid cells” in chronic inflammation. Virchows Arch A Pathol Anat Histopathol 1989; 414 (04) 285-298
  • 9 Weiss SW, Enzinger FM. Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer 1978; 41: 2250-2266