J Korean Med Sci.
2003 Aug;18(4):609-613. 10.3346/jkms.2003.18.4.609.
Primary Intraosseous Malignant Fibrous Histiocytoma of the Skull: A Case Report
- Affiliations
-
- 1Department of Pathology, Inje University, Seoul Paik Hospital, Seoul, Korea. meeah@hitel.net
- 2Department of Radiology, Inje University, Seoul Paik Hospital, Seoul, Korea.
- 3Department of Neurosurgery, Inje University, Seoul Paik Hospital, Seoul, Korea.
- 4Department of Pathology, College of Medicine, Kyung Hee University, Seoul, Korea.
- KMID: 648920
- DOI: http://doi.org/10.3346/jkms.2003.18.4.609
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.
MeSH Terms
-
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
