Radiation-induced malignant fibrous histiocytoma in patients with nasopharyngeal carcinoma.
OBJECTIVE
To evaluate the prevalence, 15-year cumulative incidence, time interval, and prognosis of radiation-induced malignant fibrous histiocytoma of the head and neck in long-term survivors of nasopharyngeal carcinoma.


METHODS
Cohort.


METHODS
Tertiary care hospital.


METHODS
Eight long-term survivors of nasopharyngeal carcinoma with malignant fibrous histiocytoma in the maxillary sinus or nasal cavity.


METHODS
Survival of postirradiation malignant fibrous histiocytoma in patients with nasopharyngeal carcinoma.


RESULTS
The prevalence of radiation-induced malignant fibrous histiocytoma in long-term survivors of nasopharyngeal carcinoma was 0.38%. The 15-year cumulative incidence was 2.2%. Most tumors occurred in the maxillary sinus and were characterized by spindle-shaped tumor cells with plump nuclei arranged in a whorl or storiform pattern in a fibrous stroma. The mean interval between malignant fibrous histiocytoma and nasopharyngeal carcinoma was 121 months. Local recurrence developed in all cases within 9 months after surgery. Six patients died of disease without distant metastasis within 30 months. Two patients were alive with disease for 20 and 32 months, respectively.


CONCLUSIONS
Radiation-induced malignant fibrous histiocytoma in the head and neck region in long-term survivors of nasopharyngeal carcinoma is rare. It takes a long time to occur after irradiation and is locally invasive with poor prognosis.
Ko
J Y
JY
Department of Otolaryngology, National Taiwan University Hospital, Taipei.
Chen
C L
CL
Lui
L T
LT
Hsu
M M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D005260:Female; D018219:Histiocytoma, Benign Fibrous / Q000209:etiology*; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology / Q000528:radiation effects; D008444:Maxillary Sinus Neoplasms / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology / Q000528:radiation effects*; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009305:Nasopharynx / Q000473:pathology / Q000528:radiation effects; D009381:Neoplasms, Radiation-Induced / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*