Cholesterotic fibrous histiocytoma– a rare variant of a common presentation – a case report

: Introduction: Here we report a case of a forty-eight year old man with a longstanding firm, asymptomatic nodule on the left upper arm who presented to clinic with a one year history of the lesion slowly enlarging to a size of 15mm by 13mm and becoming faintly pigmented. Case Presentation: Initial concerns about the possibility of a nodular malignant melanoma meant that the lesion was excised with a 2mm 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. Conclusion: These findings confirmed the presence of a cholesterotic fibrous histiocytoma, a very rare variant of a common dermatological presentation.