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Fibrous Histiocytoma of the Tarsus: Clinical and Immunohistochemical Observations With a Differential Diagnosis

Jakobiec, Frederick A. MD, DSc*,†; Rai, Ruju MD*,†; Yoon, Michael K. MD†,‡

doi: 10.1097/ICO.0000000000000095
Case Report

Purpose: To describe the diagnostic clinical findings and immunopathology of a fibrous histiocytoma of the upper eyelid tarsus of a 42-year-old man.

Methods: Analysis of clinical features and results of histopathologic and immunohistochemical evaluations using antibodies against the biomarkers smooth muscle actin, S100, CD1a, CD3, CD20, CD31, CD34, CD68, CD163, factor XIIIa, adipophilin, androgen receptor, and Ki-67.

Results: The skin moved over a firm lesion that was situated in the tarsus and protruded from the palpebral conjunctiva as a whitish flat-domed noninflamed mass that had caused an irritating corneal epitheliopathy. Histopathologically, there was a storiform or spiral nebular growth pattern, a moderate amount of intercellular collagen, and no nuclear atypia or mitotic activity. The main immunohistochemical findings were CD34 and smooth muscle actin negativity among the tumor cells and a scarcity of CD68/163 histiocytes. Androgen receptors were identified in the tumor cells.

Conclusions: CD34 histiocytoma of the tarsus is a rare, benign, and separate entity from a CD34+ solitary fibrous tumor. Conservative tarsectomy is curative.

*David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA;

Department of Ophthalmology, Harvard Medical School; and

Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA.

Reprints: Frederick A. Jakobiec, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Suite 328, Boston, MA 02114 (e-mail: fred_jakobiec@meei.harvard.edu).

The authors have no funding or conflicts of interest to disclose.

Received November 25, 2013

Accepted January 15, 2014

© 2014 by Lippincott Williams & Wilkins.