Abstract
We retrospectively analyzed the diagnosis and treatment process of one patient with recurrent undifferentiated pleomorphic sarcoma (UPS) of infratemporal fossa and made a definite diagnosis by combining the imaging and pathological examination results. After treatment failure with 2 cycles of chemotherapy and several surgeries, UPS was eventually treated by surgery + carbon ion radiotherapy, and MRI reexamination showed no relapse. Head and neck UPS is located deeply, easily recurs after operation, and difficult to be resected completely by surgery, with a gradually shortened interval of relapse over the number of surgeries, which becomes a treatment challenge. After the last surgery, the patient received carbon ion radiotherapy, with a good therapeutic effect, and no sign of relapse just before sending this article. Based on the above advantages, we have concluded that surgery + carbon ion radiotherapy is a new effective pathway to treat head and neck UPS.
Highlights
Undifferentiated pleomorphic sarcoma (UPS) may occur in any organ, most frequently in soft tissues of limbs and retroperitoneal space, but rarely in head and neck; it originates from mesenchymal tissues, and its incidence rate accounts for 1% of all malignant tumors (1)
According to WHO latest classification standard in 2013, the concept of malignant fibrous histiocytoma (MFH) was replaced by UPS (2)
UPS highly occurs at an age of 60–70 years, with a similar morbidity in males and females; it is frequently seen in limbs, trunk, head and neck, and other organs and tissues, and located deeply, has a high tumor grade and high malignancy, and recurs after operation (3)
Summary
Undifferentiated pleomorphic sarcoma (UPS) may occur in any organ, most frequently in soft tissues of limbs and retroperitoneal space, but rarely in head and neck (higher malignancy, easier relapse and metastasis, and poorer prognosis); it originates from mesenchymal tissues, and its incidence rate accounts for 1% of all malignant tumors (1). Skull base MRI examination in May 2016 showed compression-caused displacement of left temporal lobe, and a mass shadow in left infratemporal fossa— middle cranial fossa, with non-uniform signals, predominantly T1 and T2 equisignals in the lesion, patchy slightly low T1 and significantly high T2 signals in the lesion center, nearly a clear and smooth border, and localized mild lobulation, in a size of 30.5 mm (AP) × 39.2 mm (LR) × 29.5 mm (HL), and surrounded by multiple circuitously routing flowing-void vascular shadows. The above examination and treatment items have obtained the informed consent from the patient who participated in clinical investigations
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