Primary Intraosseous Malignant Fibrous Histiocytoma of the Skull: A Case Report.
10.3346/jkms.2003.18.4.609
- Author:
Mee JOO
1
;
Ghi Jai LEE
;
Young Cho KOH
;
O Ki KWON
;
Yong Koo PARK
Author Information
1. Department of Pathology, Inje University, Seoul Paik Hospital, Seoul, Korea. meeah@hitel.net
- Publication Type:Case Report
- Keywords:
Histiocytic Disorders;
Malignant;
Skull Neoplasms;
Parietal Bone
- MeSH:
Actins/biosynthesis;
Adult;
Brain/pathology;
Desmin/biosynthesis;
Female;
Giant Cells/metabolism;
Histiocytoma, Fibrous/*diagnosis;
Human;
Immunohistochemistry;
Magnetic Resonance Imaging;
Mitosis;
Muscle, Smooth/metabolism;
MyoD Protein/biosynthesis;
Protein p53/biosynthesis;
S100 Proteins/biosynthesis;
Skull Neoplasms/*diagnosis;
Tomography, X-Ray Computed;
Vimentin/biosynthesis;
alpha 1-Antitrypsin/biosynthesis
- From:Journal of Korean Medical Science
2003;18(4):609-613
- CountryRepublic of Korea
- Language:English
-
Abstract:
Malignant fibrous histiocytoma(MFH) is a rare primary neoplasm that constitutes less than 1% of the malignant tumors of bone, and involvement of the skull is very rare. We present a case of malignant fibrous histiocytoma of the skull, presenting an intraosseous lesion in a 43-yr-old woman. She had a rapidly growing, tender mass in the right parietal region. A plain radiograph showed an osteolytic lesion of the right parietal bone. Magnetic resonance imaging revealed that the lesion showed heterogeneous low signal intensity on T1-weighted images and slightly high signal intensity on T2-weighted images. No evidence of an extraosseous extension to the adjacent dura and soft tissue was found, and a wide excision of the parietal bone was performed. Histologically, the tumor was a typical MFH displaying pleomorphic spindle cells in a storiform pattern. The results of immunohistochemical stainings revealed that the tumor cells were positive for vimentin, alpha-1-antitryp-sin, and p53, and negative for smooth muscle actin, S100 protein, desmin, and MyoD1. Three months later, a mainly cystic, recurrent mass was developed at the previously operated site. Before the resection, we first performed the percutaneous aspiration cytology, revealing diagnostic multinucleated pleomorphic cells. There-after, she had to receive repetitive resections of recurrent or residual lesions, and she died of postoperative meningoencephalitis two years after the first operation.
