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Hemosiderotic Fibrolipomatous Tumor

Last updated Feb. 24, 2020

Approved by: Maulik P. Purohit MD, MPH

Hemosiderotic Fibrolipomatous Tumor (HFLT) is an infrequent tumor of the soft tissues, occurring mostly in the subcutaneous tissues of the lower extremity (leg), with a potential for aggressive behavior.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Haemosiderotic Fibrolipomatous Tumour
  • Hemosiderotic Fibrohistiocytic Lipomatous Lesion (HFLL)
  • HFLT (Hemosiderotic Fibrolipomatous Tumor)

What is Hemosiderotic Fibrolipomatous Tumor? (Definition/Background Information)

  • Hemosiderotic Fibrolipomatous Tumor (HFLT) is an infrequent tumor of the soft tissues, occurring mostly in the subcutaneous tissues of the lower extremity (leg), with a potential for aggressive behavior. The tumor is also known as Hemosiderotic Fibrohistiocytic Lipomatous Lesion (HFLL)
  • Generally, middle-aged and older adults are prone to Hemosiderotic Fibrolipomatous Tumor. The cause of tumor formation is not well-defined. However, some reports indicate that the tumor development may be a reactive process that occurs against a background of trauma or blood vessel (vascular) diseases
  • The tumor appears as a single mass that can grow to large sizes, usually on the foot or ankle. Hemosiderotic Fibrolipomatous Tumor can cause pain and discomfort, thereby affecting the quality of life
  • A complete surgical excision is used to treat Hemosiderotic Fibrolipomatous Tumor. The prognosis is generally excellent on adequate treatment; however, the chances of tumor recurrence is high (when incompletely removed)

Who gets Hemosiderotic Fibrolipomatous Tumor? (Age and Sex Distribution)

  • Hemosiderotic Fibrolipomatous Tumors are very rare tumors that occurs in slightly older adults, who are between 40-60 years old (average age 50 years)
  • In some cases, children, teenagers, and young adults, are also known to be affected. A wide age range of 12 months to75 years is observed
  • Both male and female genders are affected, although 70% of the cases are seen in females (women)
  • There is no known ethnic or racial preference observed

What are the Risk Factors for Hemosiderotic Fibrolipomatous Tumor? (Predisposing Factors)

No risk factors have been specifically identified with regards to Hemosiderotic Fibrolipomatous Tumor.

  • However, many reports indicate that there may be a preceding history of trauma (some tumors are seen to form at surgery sites)
  • Vasculopathy or vascular disease (any condition affecting the blood vessels) is also believed to be a risk for HFLT development

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hemosiderotic Fibrolipomatous Tumor? (Etiology)

The exact cause and mechanism of Hemosiderotic Fibrolipomatous Tumor formation is unknown.

  • Some scientific researchers think that it may be a reactive process, since the tumor is observed to form at sites of tissue injury (which may be due to a trauma or vascular disease)
  • Some tumors have shown a loss of chromosomal material or the presence of chromosomal imbalances. But, further research is necessary to well characterize the cause of tumor formation

What are the Signs and Symptoms of Hemosiderotic Fibrolipomatous Tumor?

Hemosiderotic Fibrolipomatous Tumor signs and symptoms may include:

  • The tumors may be present as slow-growing mass below the skin, in the subcutaneous tissues
  • It can be locally aggressive and affect the surrounding tissues and muscles
  • Many individuals experience pain at the tumor site
  • In nearly all cases, HFLT forms on the distal extremities (hands or feet). The most common location is the top of the foot (dorsum) followed by the ankle (together accounting for about 85% of the cases)
  • Other locations include the hand, calf of the leg, and the thigh
  • The tumors may cause reduced motion range and discomfort, if present around the joints
  • The tumors can grow to large sizes (up to 19 cms is recorded); the average tumor size is about 8 cm

How is Hemosiderotic Fibrolipomatous Tumor Diagnosed?

A diagnosis of Hemosiderotic Fibrolipomatous Tumor may involve the following tests and exams:

  • Physical examination with comprehensive evaluation of the individual’s medical history
  • CT scan, MRI scan of the affected region
  • Tissue biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hemosiderotic Fibrolipomatous Tumor?

The possible complications of Hemosiderotic Fibrolipomatous Tumor may include the following:

  • Walking difficulties, difficulty wearing footwear, etc. which can interfere with one’s routine activities and affect the quality of life
  • Damage to muscles, vital nerves, and blood vessels, during surgery
  • Recurrence of HFLT after surgery, which is observed in 1 in 2-3 cases

How is Hemosiderotic Fibrolipomatous Tumor Treated?

Treatment measures for Hemosiderotic Fibrolipomatous Tumor may include:

  • A complete surgical excision of the tumor with removal of the entire lesion is the preferred method to treat HFLT. If it is not fully removed, then the tumor might recur
  • Post-operative care is important: A minimum activity level is to be ensured, until the surgical wound heals
  • Follow-up care with regular screening and check-ups are important and strongly advised

How can Hemosiderotic Fibrolipomatous Tumor be Prevented?

  • Current medical research have not established a way of preventing Hemosiderotic Fibrolipomatous Tumor
  • Regular medical screening at periodic intervals with blood tests, scans, and physical examinations, are mandatory for those who have already endured the tumor, due to its high recurrence rates

What is the Prognosis of Hemosiderotic Fibrolipomatous Tumor? (Outcomes/Resolutions)

  • The prognosis of Hemosiderotic Fibrolipomatous Tumor is good with surgical intervention. A complete excision usually results in a low tumor recurrence rate
  • The tumor recurrence rate is known to be high (about 30-50%); and recurrence may take place after many years, especially if the tumor is inadequately excised
  • HFLTs are not known to undergo malignant transformations and no metastasis has been reported so far

Additional and Relevant Useful Information for Hemosiderotic Fibrolipomatous Tumor:

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Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 29, 2016
Last updated: Feb. 24, 2020