title: Primary intraosseous malignant fibrous histiocytoma of the skull: a case report.
abstract: Malignant fibrous histiocytoma (MFH) is a rare primary neoplasm that constitutes less than 1% of the malignant tumors of bone, and involvement of the skull is very rare. We present a case of malignant fibrous histiocytoma of the skull, presenting an intraosseous lesion in a 43-yr-old woman. She had a rapidly growing, tender mass in the right parietal region. A plain radiograph showed an osteolytic lesion of the right parietal bone. Magnetic resonance imaging revealed that the lesion showed heterogeneous low signal intensity on T1-weighted images and slightly high signal intensity on T2-weighted images. No evidence of an extraosseous extension to the adjacent dura and soft tissue was found, and a wide excision of the parietal bone was performed. Histologically, the tumor was a typical MFH displaying pleomorphic spindle cells in a storiform pattern. The results of immunohistochemical stainings revealed that the tumor cells were positive for vimentin, alpha-1-antitrypsin, and p53, and negative for smooth muscle actin, S100 protein, desmin, and MyoD1. Three months later, a mainly cystic, recurrent mass was developed at the previously operated site. Before the resection, we first performed the percutaneous aspiration cytology, revealing diagnostic multinucleated pleomorphic cells. Thereafter, she had to receive repetitive resections of recurrent or residual lesions, and she died of postoperative meningoencephalitis two years after the first operation.
authors.affiliation: Department of Pathology, Inje University, Seoul Paik Hospital, Seoul, Korea. meeah@hitel.net
authors.forename: Mee
authors.initials: M
authors.lastname: Joo
authors.forename: Ghi Jai
authors.initials: GJ
authors.lastname: Lee
authors.forename: Young-Cho
authors.initials: YC
authors.lastname: Koh
authors.forename: O-Ki
authors.initials: OK
authors.lastname: Kwon
authors.forename: Yong-Koo
authors.initials: YK
authors.lastname: Park
mesh_terms: D000199:Actins / Q000096:biosynthesis; D000328:Adult; D001921:Brain / Q000473:pathology; D003893:Desmin / Q000096:biosynthesis; D005260:Female; D015726:Giant Cells / Q000378:metabolism; D018219:Histiocytoma, Benign Fibrous / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008938:Mitosis; D009130:Muscle, Smooth / Q000378:metabolism; D017570:MyoD Protein / Q000096:biosynthesis; D009418:S100 Proteins / Q000096:biosynthesis; D012888:Skull Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis; D014746:Vimentin / Q000096:biosynthesis; D000515:alpha 1-Antitrypsin / Q000096:biosynthesis
chemical_list: D000199:Actins; D003893:Desmin; D017570:MyoD Protein; C057363:MyoD1 myogenic differentiation protein; D009418:S100 Proteins; D016159:Tumor Suppressor Protein p53; D014746:Vimentin; D000515:alpha 1-Antitrypsin