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Primary cutaneous malignant fibrous histiocytoma: A case report.

Ashitha C. Bose, Vikram Kate, Nilakantan Ananthakrishnan, Sowmya Srinivasan

Med Sci Monit 2006; 12(7): CS61-63

ID: 452210


Background: Malignant fibrous histiocytoma (MFH) is one of the commonestsoft tissue sarcomas to occur in the extremities, but presentation as a primary cutaneous lesion is rare.MFH can present as a cutaneous lesion in the form of a primary tumor or as metastasis from MFH at othersites, such as primary MFH of the breast; however, both presentations are very rare. Case Report: Wereport here a 55-year-old male patient with cutaneous MFH on the right thigh region. The patient presentedwith two swellings on the outer aspect of the thigh of three months' duration, which ulcerated followingthe first month. The swellings were non-tender, soft, compressible, and not fixed to underlying structures.Histopathologic examination of the excised tumor revealed highly pleomorphic spindle-shaped cells arrangedin sheets and irregular fascicles with a focal storiform pattern. Many thin-walled blood vessels andfocal inflammatory cell infiltration with occasional focus of myxoid change was seen. Storiform-pleomorphictype of MFH grade II was diagnosed. Wide local excision was done. The patient made an uneventful recovery.Conclusions: Although MFH is one of the commonest soft tissue sarcomas, cutaneous presentation is veryrare. A high index of suspicion is necessary to keep this possibility in mind, as it can present in differentforms, including the pedunculated types, which can be compressible. MFH variants such as atypical fibroushistiocytoma or atypical fibroxanthoma can occur sometimes as cutaneous MFH. Wide local excision is commonlypossible in most of the cases for therapy.

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