Subcutaneous benign Fibrous Histiocytoma of upper eyelid: A Review of the histopathological Database at a Single Faculty in Japan

A 57 year-old Japanese man presented with an asymptomatic, ?7 mm subcutaneous nodule on his right upper eyelid. Findings of histopathology and immunohistochemistry led to the diagnosis of benign fibrous histiocytoma (BFH) (i.e. dermatofibroma). At the department of dermatology, Asahikawa Medical University, 803 lesions of 777 cases have been registered as BFH with histopathological database. Nine lesions (1.12%) occurred on the face and only the present case showed subcutaneous facial BFH. While 5 cases of disseminated BFH associated with autoimmune diseases, exemplified by systemic lupus erythematosus, showed multiple lesions on the trunk and extremities, the face was completely spared, suggesting distinct histogenesis. However, immunohistochemistry for the markers associated with BFH, such as CD34, factor XIIIa, podoplanin, S-100, α-smooth muscle actin, and CD68, could not determine any difference from typical BFH. Subcutaneous BFH on the face is extremely rare, however, both facial and subcutaneous BFH show more frequent recurrence rate than the classical subtype. Surgeon should be aware of BFH as one of subcutaneous tumors on the face, and careful observation is mandatory following surgical excision.