Malignant Fibrous Histiocytoma

Epidemiology

Malignant fibrous histiocytoma was uncommonly reported before the 1970s. Since then, this tumor has become the most frequently reported soft tissue sarcoma in most major institutions. About 3 to 10% of all malignant fibrous histiocytoma occur in the head and neck. There is no sex predilection and the tumor occurs most frequently in adults 50 to 60 years of age.

Clinical Findings

Patients usually present with a large mass, with or without pain. Symptoms and signs depend on the location of the tumor and compression of surrounding structures.

Pathology

These tumors arise from tissue histiocytes. They grow and invade along fascial planes. They usually have well-defined margins but are not encapsulated. The verifying histologic picture is the storiform pattern of fibroblastic and histiocytic cells. Most tumors show cellular pleomorphism with multiple giant cells.

Treatment

The prognosis is poor. There is a very high recurrence rate following surgery. The tumor is radioresistant and does not respond significantly to chemotherapy. Tumors also show a high propensity to metastasize.