Benign fibrous histiocytoma of the choroid

Benign fibrous histiocytoma (BFH) is a common soft tissue tumour. However, its occurrence in the orbit was not well recognised in the past. It is only in recent years that this condition has become more frequently diagnosed. Now, it is believed to be the commonest mesenchymal tumour of the orbit in adults. Its occurrence in the uveal tract is, however, exceedingly rare. Only one case of presumed fibrous histiocytoma of the choroid has been reported in the literature. We report herein a case of BFH of the choroid in the left eye of a Chinese woman. The patient presented with a huge but asymptomatic raised choroidal mass. Results of choroidal biopsy showed no sign of malignancy but definitive diagnosis could not be made. Enucleation was finally performed. The diagnosis was made on detailed evaluation of the results of the immunohistochemical staining and the ultrastructural findings. The patient remained well at the latest follow-up, which was 33 months after enucleation. Although BFH of the choroid is vary rare, its benign nature and the availability of choroidal biopsy for tissue diagnosis make it important to include this as one of the differential diagnoses for amelanotic choroidal mass.