A Rare Tumor of Scalp - Giant Multiple Cellular Histiocytofibroma

Abstract

Histiocytofibroma or dermatofibroma is a rare benign cutaneous tumor present preferentially in the dermis. Histiocytofibroma is most frequent benign tumor, but some specific morphological forms may present local recurrences and can cause lymph node and visceral metastases. The trunk and limbs represent the most classically described topography, other locations are known like face and scalp. Histiocytofibroma is most often present as a unique lesion: papule or nodule, giant form is not common and it is characterized by a large tumor volume (5 cm or more). The cellular histological variant is a rare subtype. We report a case of a 56-year-old male patient with no particular past medical history, who presented with a fronto-parietal cutaneous large tumor evolved for 2 years, gradually increasing in volume, measuring 7 cm in diameter, with regular contours, flesh colored, and peripheral vascularization on the surface of the lesion, it was firm and adherent to bone plane at palpation, along with seven other small lesions, the largest of which was 2 cm. The CT scan did not show any bone invasion. Surgical management consisted of large excision with 1 cm free margins. histological and immunohistochemical findings were in favor of cellular histiocytofibroma. The substance loss was covered by skin graft after complete budding. A 26 months follow up results were good without recurrence.