Fibrous histiocytoma of the breast

Two Saudi females aged 26 and 14 years presented with giant fibroadenomas. The histology after surgical excision revealed benign fibrous histiocytomas. Patient one remained well with no apparent recurrence after 5 years of the initial excision. However, in patient 2 the benign fibrous histiocytoma recurred with low-grade malignancy after a year of the initial excision. A high-grade recurrence developed after 3 months of the second excision. This was treated by radical wide excision. It was felt later that mastectomy was more appropriate and therefore was performed. The second patient highlights the fact that malignant histiocytoma can occur in the pediatric age group and that the initial surgical treatment of benign fibrous histiocytoma should be aggressive to avoid recurrence and development of malignant changes. We believe that our second patient is the youngest age ever reported in the literature with malignant fibrous histiocytoma.