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Malignant fibrous histiocytoma of the face: report of a case.

Seper L, Schwab R, Kiattavorncharoen S, Büchter A, Bánkfalvi A, Joos U, Piffkó J, Kruse-Loesler B - Head Face Med (2007)

Bottom Line: Radical tumour resection was completed by extended parotidectomy and neck dissection; the skin defect was covered by a regional bi-lobed flap.Full functional and cosmetic recovery was achieved; follow-up has been uneventful more than two years postoperatively.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cranio-Maxillofacial Surgery, University of Muenster, Waldeyerstr, 30, 48149 Muenster, Germany. seper@uni-muenster.de

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.

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Related in: MedlinePlus

Intraoperative view after conservative neck dissection and prior to tumour removal, parotidectomy and placing of the local bi-lobed flap. The safety margin is well marked around the tumour and the preparation of the flap is completed.
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Figure 4: Intraoperative view after conservative neck dissection and prior to tumour removal, parotidectomy and placing of the local bi-lobed flap. The safety margin is well marked around the tumour and the preparation of the flap is completed.

Mentions: Clinical staging investigations of the current malignancy [chest X-ray, MRI-scan of the neck and skull, abdominal and neck ultrasound, bone scintigraphy] showed superficial infiltration of the cutis and subcutis. Neither infiltration of the Masseter nor metastases in the regional lymph nodes or elsewhere were found. Radical excision of the tumour was completed by parotidectomy and modified neck dissection, which resulted in a cosmetic defect of the right face that was immediately corrected by a local bi-lobed flap (Fig. 4). No postoperative radio- or chemotherapy was applied. Two years postoperatively, the patient was alive and well with full cosmetic and functional recovery. (Fig. 5) She died after a heart attack three years after surgery without any signs of tumour recurrence or metastasis. Autopsy was not carried out.


Malignant fibrous histiocytoma of the face: report of a case.

Seper L, Schwab R, Kiattavorncharoen S, Büchter A, Bánkfalvi A, Joos U, Piffkó J, Kruse-Loesler B - Head Face Med (2007)

Intraoperative view after conservative neck dissection and prior to tumour removal, parotidectomy and placing of the local bi-lobed flap. The safety margin is well marked around the tumour and the preparation of the flap is completed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2211745&req=5

Figure 4: Intraoperative view after conservative neck dissection and prior to tumour removal, parotidectomy and placing of the local bi-lobed flap. The safety margin is well marked around the tumour and the preparation of the flap is completed.
Mentions: Clinical staging investigations of the current malignancy [chest X-ray, MRI-scan of the neck and skull, abdominal and neck ultrasound, bone scintigraphy] showed superficial infiltration of the cutis and subcutis. Neither infiltration of the Masseter nor metastases in the regional lymph nodes or elsewhere were found. Radical excision of the tumour was completed by parotidectomy and modified neck dissection, which resulted in a cosmetic defect of the right face that was immediately corrected by a local bi-lobed flap (Fig. 4). No postoperative radio- or chemotherapy was applied. Two years postoperatively, the patient was alive and well with full cosmetic and functional recovery. (Fig. 5) She died after a heart attack three years after surgery without any signs of tumour recurrence or metastasis. Autopsy was not carried out.

Bottom Line: Radical tumour resection was completed by extended parotidectomy and neck dissection; the skin defect was covered by a regional bi-lobed flap.Full functional and cosmetic recovery was achieved; follow-up has been uneventful more than two years postoperatively.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cranio-Maxillofacial Surgery, University of Muenster, Waldeyerstr, 30, 48149 Muenster, Germany. seper@uni-muenster.de

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.

Show MeSH
Related in: MedlinePlus