Radiation-induced malignant fibrous histiocytoma of the occipital: a case report

Jian Li,Peng-Fei Zhang,Guo-Bin Zhang,Li-Jiang Han,Jun-Ting Zhang

doi:10.1186/1477-7819-12-98

Abstract

Malignant fibrous histiocytoma (MFH) is a rare neoplasm exhibiting a propensity for aggressive clinical behavior. Effective treatment modality is surgical resection with wide margins, but its rate of recurrence and metastasis is still high. Early detection and complete excision of the tumor is necessary. A MFH of the occipital developed in a 51-year-old woman eight years after surgery and radiation for medulloblastoma of the cerebellar vermis. The secondary neoplasm arose at the site of tumor resection within the irradiated field, and was resected. The development of sarcomas is a recognized complication of radiation therapy. The final diagnosis after the operation was MFH. Radiation-induced sarcoma (RIS) is well known, but radiation-induced MFH is relatively rare in the head and neck region, especially in the occipital. The imaging findings are not diagnosis specific, but strict follow-up within the radiation field by computerized tomography (CT) and magnetic resonance imaging (MRI) and appreciation of the expected latency period may help in providing the diagnosis of RIS.

Highlights

Malignant fibrous histiocytoma (MFH) is one of the most common soft tissue sarcomas of adulthood and has been reported in various organs
The purpose of this report is to improve the understanding of the clinical behavior, predictors of biological aggressiveness, and histological and immunohistochemical features of MFH after radiotherapy for medulloblastoma of the cerebellar vermis
MFH tumor is composed of an admixture of spindle-shaped fibroblastic tumor cells and bizarre mononuclear histiocytic tumor cells arranged in a storiform pattern with some multinucleated giant cells [7]

Summary

Introduction

Malignant fibrous histiocytoma (MFH) is one of the most common soft tissue sarcomas of adulthood and has been reported in various organs. MFH are rare tumors within the central nervous system. They have been reported in the brain, dura mater, cranial bones, spine and peripheral nerves [2,3]. Radiotherapy is one of the most important treatments of malignant tumors in the head and neck region, but it is known to induce major side effects such as radionecrosis and oncogenesis. MFH has been reported to occur with increased frequency in patients who have been treated with radiotherapy for malignant disease [4]. The purpose of this report is to improve the understanding of the clinical behavior, predictors of biological aggressiveness, and histological and immunohistochemical features of MFH after radiotherapy for medulloblastoma of the cerebellar vermis

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Conclusion