Cholesterotic Fibrous Histiocytoma: A Rare Variant of a Common Presentation: A Case Report

Here, we report a case of a 48-year-old man with a longstanding firm, asymptomatic nodule on the left upper arm who presented to clinic with a 1 year history of the lesion slowly enlarging to a size of 15 mm by 13 mm and becoming faintly pigmented.

Initial concerns about the possibility of a nodular malignant melanoma meant that the lesion was excised with a 2 mm margin; however, histology demonstrated a hyperplastic epidermis with an underlying intradermal lesion with fibrocyte-like cells with a storiform and haphazard arrangement. Occasional histiocytes were present, many of which were xanthomatous. Numerous, almost confluent cleft-like spaces representing cholesterol deposition were noted as well as peripheral entrapment of collagen bundles.

These findings confirmed the presence of a cholesterotic fibrous histiocytoma, a very rare variant of a common dermatological presentation.