Malignant fibrous histiocytoma of the pericranium: case report

Benign fibrous histiocytoma of the pterygopalatine fossa with intracranial extension

A very rare case of fibrous histiocytoma arising in the pterygopalatine fossa with intracranial extension is described. Despite the histologic absence of nuclear pleomorphism, the tumor rapidly recurred after complete surgical resection. The patient, a 45 year old male, died shortly thereafter. The aggressive nature of our patient's tumor confirms previous observations that an aggressive radiographic appearance has prognostic value when dealing with skeletal and soft tissue tumors. The benefit of multimodal therapy has not been established in these rare head and neck lesions. In the subset of fibrous histiocytomas that invade bone, however adjunctive treatment with radiation and or chemotherapy may be appropriate.

Malignant fibrous histiocytoma originating at the site of a previous fronto-temporal craniotomy

Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma in adults. MFH occurrence in the bones of the skull is extremely rare, and, to our knowledge, it has not been reported in a patient with a history of craniotomy. A 69 year old woman presented with a large mass in the left fronto-temporal bone. The patient's medical history included a left fronto-temporal craniotomy 8 years prior to the present admission for neck clipping of an aneurysm of the left middle cerebral artery. Following preoperative work up, the skull tumor was resected, and pathology showed that the mass was composed of spindle-shaped fibroblastic cells arranged in a storiform pattern, and of numerous multinucleated giant cells. A diagnosis of MFH was established. The patient died of intracranial hemorrhage from a subsequent tumor 22 months after resection of the first tumor.