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Disease&Treatment/Oculoplastics
Orbital fibrous histiocytoma pathological characteristics and ophthalmological clinical occurrence site, symptoms, and treatment
eye_doc 2025. 4. 21. 23:55
👁 “Fibrous Histiocytoma of the Orbit – Most Common Adult Mesenchymal Tumor”
Fibrous histiocytoma (FH) is a mesenchymal tumor composed of fibroblast- and histiocyte-like cells,
and is considered the most common primary mesenchymal tumor of the adult orbit.
It is typically located in the superonasal quadrant and presents with painless proptosis and globe displacement.
🧠 Summary Table – Orbital Fibrous Histiocytoma
FeatureDescription
| Age Group | Typically middle-aged adults |
| Location | Superonasal orbit |
| Frequency | Most common adult orbital mesenchymal tumor |
| – ~10% of all orbital tumors in head & neck region | |
| Clinical Presentation | |
| – Proptosis | |
| – Inferotemporal globe displacement | |
| – Visual changes (if optic nerve involved) | |
| Histologic Features | |
| – Pleomorphic spindle cells | |
| – Mixed inflammation and collagen bundles | |
| – Often well-encapsulated | |
| – May show lipid-laden macrophages, multinucleation | |
| Treatment | |
| – Benign: local excision | |
| – Malignant: may require orbital exenteration | |
| Immunohistochemistry | Vimentin, CD68 positive (variable) |
✅ Clinical Insight
– If imaging shows well-circumscribed orbital mass with superonasal location, consider FH
– Must differentiate from dermatofibroma, giant cell tumor, sarcoma variants
– Histopathology remains diagnostic gold standard