Hemosiderotic fibrolipomatous tumor: A poorly known entity

Abstract

Hemosiderotic fibrohistiocytic lipomatous tumor (HFLT) is a rare and supposedly benign fibrolipomatous entity. Clinical and imaging features are not specific. So, histologic, immunohistochemical and molecular analyses are required for diagnosis. The clinic and pathologic aspects of this lesion are diversely reported. Moreover, its reactive or neoplastic origin is still under debate. This lesion should be treated by complete excision. It is mandatory to be aware of its tendency to harbor higher-grade lesions with aggressive outcome. We report a case of HFLT affecting the dorsum of the third right finger in a 52-year-old women, in order to describe histologic patterns of this tumor and to discuss the current literature regarding the etiopathogeny and the cytogenetic features of this rare entity.

Keywords

Hemosiderotic fibrohistiocytic lipomatous tumor / Fibroblast-like spindle cells / Mature adipocytes / Hemosiderin

CONFLICTS OF INTEREST DISCLOSURE

No conflicts of interest.

References

[1] Browne TJ, Fletcher CD. Haemosiderotic fibrolipomatous tumour (so-called haemosiderotic fibrohistiocytic lipomatous tumour): analysis of 13 new cases in support of a distinct entity. Histopathology. 2006; 48: 453-61. PMid:16487368. https://doi.org/10.1111/j.1365-2559.2006.02360.x

[2] Wettach GR, Boyd LJ, Lawce HJ, et al. Cytogenetic analysis of a hemosiderotic fibrolipomatous tumor. Cancer Genet Cytogenet. 2008; 15: 140-3. PMid:18406878. https://doi.org/10.1016/j.cancergencyto.2008.01.012

[3] Moretti VM, Brooks JS, Ogilvie CM. Hemosiderotic Fibrohistiocytic Lipomatous Lesion. A Clinicopathologic Characterization. Clin Orthop Relat Res. 2010; 468: 2808-13. PMid:20127213. https://doi.org/10.1007/s11999-010-1242-7

[4] Wilk M, Zelger BG, Zelger B. Hemosiderotic Fibrolipomatous Tumor. Am J Dermatopathol. 2016; 38(9): 714-6. PMid:26844619. https://doi.org/10.1097/DAD.0000000000000540

[5] Solomon DA, Antonescu CR, Link TM, et al. Hemosiderotic Fibrolipomatous Tumor, Not an Entirely Benign Entity. Am J Surg Pathol. 2013; 37(10): 1627-30. PMid:24025526. https://doi.org/10.1097/PAS.0b013e31829ff078

[6] Morency E, Laskin W, Lin X. Cytologic and Histologic Features of Pleomorphic Undifferentiated Sarcoma Arising in a Hybrid Hemosiderotic Fibrolipomatous Tumor and Pleomorphic Hyalinizing Angiectatic Tumor: Report of an Unusual Case with a Literature Review. Acta Cytol. 2015; 59(6): 493-7. PMid:26841226. https://doi.org/10.1159/000443319

[7] Elco CP, Marino-Enriquez A, Abraham JA, et al. Hybrid myxoinflammatory fibroblastic sarcoma/hemosiderotic fibrolipomatous tumor: report of a case providing further evidence for a pathogenetic link. Am J Surg Pathol. 2010; 34: 1723-7. https://doi.org/10.1097/PAS.0b013e3181f17d51

[8] Zreik RT, Carter JM, Sukov WR, et al. Myxoinflammatory fibroblastic sarcoma (MIFS) and hybrid hemosiderotic fibrolipomatous tumor (HFLT)/MIFS: related or not? Mod Pathol. 2015; 28(suppl 2): 30A.

[9] Marshall-Taylor C, Fanburg-Smith JC. Hemosiderotic fibrohistiocytic lipomatous lesion: ten cases of a previously undescribed fatty lesion of the foot/ankle. Mod Pathol. 2000; 13: 1192-9. PMid:11106076. https://doi.org/10.1038/modpathol.3880221

[10] Zreik RT, Carter JM, Sukov WR, et al. TGFBR3 and MGEA5 rearrangements are much more common in “hybrid” hemosiderotic fibrolipomatous tumor-myxoinflammatory fibroblastic sarcomas than in classical myxoinflammatory fibroblastic sarcomas: a morphological and fluorescence in situ hybridization study. Hum Pathol. 2016 Jul; 53: 14-24.

[11] Carter JM, Sukov WR, Montgomery E, et al. TGFBR3 and MGEA5 rearrangements in pleomorphic hyalinizing angiectatic tumors and the spectrum of related neoplasms. Am J Surg Pathol. 2014; 38(9): 1182-992. PMid:24705316. https://doi.org/10.1097/PAS.0000000000000212

[12] Antonescu CR, Zhang L, Nielsen GP, et al. Consistent t(1;10) with rearrangements of TGFBR3 and MGEA5 in both myxoinflammatory fibroblastic sarcoma and hemosiderotic fibrolipomatous tumor. Genes Chromosomes Cancer. 2011 Oct; 50(10): 757-64. https://doi.org/10.1002/gcc.20897