J Korean Surg Soc JKSS Journal of the Korean Surgical Society 1226-0053 2093-0488 The Korean Surgical Society 10.4174/jkss.2011.80.2.147 Case Report Malignant Fibrous Histiocytoma Originating in the Short-term after Excision Kim Ki Hoon M.D. Kim Jin Su M.D. Park Sung Jin M.D. Kim Woon-Won M.D. Oh Sang Hoon M.D. Choi Su Im M.D. 1 Department of Surgery, Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea. Department of Pathology, Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea. Corresponding author (medhun@hanmail.net) 02 2011 07 02 2011 80 2 147 150 22 10 2010 21 12 2010 Copyright © 2011 The Korean Surgical Society 2011

MFH is rare with just a few thousand cases diagnosed each year. We report a case of right flank malignant fibrous histiocytoma (MFH) in the short-term after tumor excision. A 47-year-old woman visited hospital after being diagnosed with MFH. Resection margin was positive, so we planned for wide excision. While awaiting surgery, 1.5 cm sized new mass occurred adjacent to the incision site. The patient underwent wide excision. Postoperative pathologic findings observed a 1.0 cm diameter mass with infiltrative borders in the subcutaneous fat. It was composed of spindle or epithelial cell showing severe polymorphism. Many mitotic cells were observed including atypia. In immunohistochemical study, tumor cells were negative for smooth muscle actin, desmin, myoglobin, S100, cytokeratin, and positive for CD68, and thus diagnosed as pleomorphic MFH. With the purpose of improving local tumor control, radiation therapy was performed after wide excision.

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PET CT findings. There is a mild FDG-avid lesion in right flank (skin and subcutaneous area).

(A) Microscopic findings of the right flank mass. The tumor has un encapsulated ill-defined margin infiltrating surrounding subcutaneous adipose tissue (H&E, ×12.5). (B) Microscopic findings of the right flank mass. The spindle tumor cells grow in fascicular pattern (H&E, ×100). (C) Microscopic findings of the right flank mass. The tumor cells have markedly pleomorphic nuclei with frequent mitoses (H&E, ×400).