Malignant fibrous histiocytoma of the scalp. Multidisciplinary treatment.
BACKGROUND
Malignant fibrous histiocytomas (MFH) are uncommon in the skin, and even less frequent on the scalp. On the scalp they are often very difficult to excise and it is even more difficult to close the resulting wound.


OBJECTIVE
To review all malignant fibrous histiocytomas diagnosed and treated in our Department during the past 6 years, and to describe the multidisciplinary procedure employed to treat one special case of aggressive malignant fibrous histiocytoma on the scalp that recurred twice.


RESULTS
Malignant fibrous histiocytomas represent 0.01% of malignant cutaneous tumors in our area. The immediate results after a multidisciplinary treatment performed on a recurrent malignant fibrous histiocytoma located on the scalp were excellent, but recurrence was observed 6 months later. Two years later we have also treated another case of MFH on the scalp. The same surgical technique was performed, but the patient received high-dose-methotrexate-based neoadjuvant chemotherapy (HD-MTX). One year later, this patient is still alive and no signs of recurrence have been detected.


CONCLUSIONS
When malignant fibrous histiocytoma occurs on the scalp it must be treated immediately by means of an excision with a large peripheral edge of 2 cm from the visual or CAT limits of the lesion, since the first treatment must be definitive.
Camacho
F M
FM
Department of Medical-Surgical Dermatology and Venereology, Hospital Universitario Virgen Macarena, Facultad de Medicina, Sevilla, Spain. camachodp@meditex.es
Moreno
J C
JC
Murga
M
M
Proaño
J
J
Cantillana
J
J
Naranjo
M
M
Martínez-Sahuquillo
A
A
Macher
G
G
Romero
F
F
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D018219:Histiocytoma, Benign Fibrous / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012535:Scalp / Q000187:drug effects / Q000528:radiation effects / Q000601:surgery*; D012878:Skin Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D016038:Skin Transplantation; D014057:Tomography, X-Ray Computed
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate