Zusammenfassung
Zu den fibrohistiozytären Tumoren gehören verschiedene Entitäten, die durch fibroblastoide Spindelzellen und Histiozyten charakterisiert werden. Zu den Hauptvertretern dieser Gruppe gehören das benigne fibröse Histiozytom (BFH), das niedrig maligne Dermatofibrosarcoma protuberans (DFSP) und das maligne fibröse Histiozytom (MFH). Wir beschreiben den Fall eines benignen Tumors der Großzehe, der zu knöchernen Defekten am Nagelkranzfortsatz führte. Eine 54-jährige Patientin stellte sich mit einem rezidivierenden, ca. 2 cm großen, derben, schmerzhaften Tumor der linken Großzehe vor. Sie litt bereits seit 10 Jahren unter eingewachsenen Zehnägeln und hatte 5 Jahre zuvor einen Tumor an gleicher Stelle entfernt bekommen. Histologisch zeigte sich ein fibrohistiozytärer Tumor mit zahlreichen Schaumzellen und storiformem Wachstumsmuster. Der Tumor war komplett CD34-negativ, nur vereinzelt waren Mitosen nachweisbar. Wir stellten die Diagnose eines benignen zellreichen fibrösen Histiozytoms (BZFH). Bei diesem Tumor kommt es insbesondere nach inkompletter Resektion häufig zu Rezidiven. Eine Schädigung des unterliegenden Knochens ist bislang noch nicht berichtet worden.
Abstract
Fibrohistiocytic tumors are characterized by the presence of fibroblast like spindle cells and histiocytes. The benign fibrous histiocytoma (dermatofibroma, BFH) as well as the malignant dermatofibrosarcoma protuberans (DFSP) and the malignant fibrous histiocytoma (MFH) belong to this group. A recurrent painful, hard 2cm tumor on the left hallux of a 54-year-old woman led to an erosion of the underlying phalanx. The patient had suffered from ingrown toenails for more than 10 years. Histologically there was a deep penetrating fibrohistiocytic tumor that grew in a storiform pattern with interspersed foam cells. The tumor was CD34 negative and mitoses were scarce. The diagnosis was benign cellular fibrous histiocytoma (BZFH). BZFH belong to the group of BFH with a high recurrence rate especially after incomplete removal. Damage to the underlying bone has not been reported so far.
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Danksagung
Unser Dank gilt den Herrn PD Dr. Thomas Mentzel, Friedrichshafen, sowie Herrn Professor Christopher D.M. Fletcher, Boston, die unsere histopathologische Diagnose bestätigt haben.
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Kurzen, H., Hartschuh, W. Benignes zellreiches fibröses Histiozytom der Großzehe mit knöchernen Defekten des Nagelkranzfortsatzes. Hautarzt 54, 453–456 (2003). https://doi.org/10.1007/s00105-002-0452-7
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DOI: https://doi.org/10.1007/s00105-002-0452-7