Case report

Malignant fibrous histiocytoma of the face: report of a case

László Seper¹ , Richárd Schwab^2* , Sirichai Kiattavorncharoen^1,3* , Andre Büchter^1,4* , Ágnes Bánkfalvi^5,6* , Ulrich Joos^1* , József Piffkó^1* and Birgit Kruse-Loesler^1*

¹  Department of Cranio-Maxillofacial Surgery, University of Muenster, Waldeyerstr. 30, 48149 Muenster, Germany

²  Cooperative Research Center, Semmelweis University, POB 131, 1367 Budapest, Hungary

³  Department of Oral and Maxillo-Facial Surgery, Mahidol University, 6 Yothe Rd.Rajthevee, 10400 Bangkok, Thailand

⁴  Group practice Engelke, Büchter, Immenkamp, Hohenzollernring 10, 48145 Muenster, Germany

⁵  Gerhard-Domagk-Institute of Pathology, University of Muenster, Domagkstraße 17, 48149 Muenster, Germany

⁶  Departments of Pathology and Neuropathology, University of Duisburg-Essen Medical School, Hufelandstraße 55, 45122 Essen, Germany

author email corresponding author email* Contributed equally

Head & Face Medicine 2007, 3:36doi:10.1186/1746-160X-3-36

Published:	18 October 2007

Abstract

Background

Soft tissue sarcomas in the head and neck region are rare and often present a difficult differential diagnosis. The aim of our presentation is to point out the complexity of the diagnosis, treatment and follow up.

Case presentation

An eighty-seven year old female patient was referred to our unit with a fast growing brownish lump on the face. Four months beforehand, a benign fibrous histiocytoma (BFH) had been removed from the same location by excision biopsy with wide tumour-free resection margins. Excision biopsy of the recurrent lesion revealed a malignant fibrous histiocytoma (MFH). Radical tumour resection was completed by extended parotidectomy and neck dissection; the skin defect was covered by a regional bi-lobed flap. No adjuvant radio- or chemotherapy was administered. Full functional and cosmetic recovery was achieved; follow-up has been uneventful more than two years postoperatively.

Discussion

Malignant transformation of BFH is extremely rare and if so, extended radical surgery may give a fair chance for a favourable outcome even in patients with advanced age.