Malignant fibrous histiocytoma of the glans penis: a case report.
BACKGROUND
Malignant fibrous histiocytoma has been regarded as the most common sarcoma of older adults. However, recent opinion regards pleomorphic malignant fibrous histiocytoma as an undifferentiated high grade pleomorphic sarcoma not otherwise classifiable utilizing current techniques available in surgical pathology. Notwithstanding controversy regarding its nomenclature, malignant fibrous histiocytoma involving the penis is exceedingly rare, with only 4 cases previously described, to our knowledge.


METHODS
An uncircumcised 73-year-old male presented with a painless, granular, partially necrotic lesion beneath the penile foreskin. There was no history of sexually transmitted disease, constitutional symptoms or dysuria. Examination of penile shaft, testicles, spermatic cord and inguinal lymph nodes were unremarkable. Biopsy revealed a markedly pleomorphic sarcoma. Subsequent, partial penectomy revealed the same lesion with an adjacent area of squamous cell carcinoma in situ.


CONCLUSIONS
Malignant fibrous histiocytoma remains a diagnosis of exclusion. The investigation requires extensive tumor sampling in search of areas of differentiation and a complete battery of immunohistochemical markers. Therapeutically important entities in the differential diagnosis that must be ruled out include other poorly differentiated sarcomas, sarcomatoid squamous cell carcinoma and desmoplastic melanoma.
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, USA.
Terrence M
TM
Katona
Alan J
AJ
Shienbaum
Larry L
LL
Wyatt
Gordon A
GA
Brown
Liang
L
Cheng
D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D051677:Histiocytoma, Malignant Fibrous / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D010412:Penile Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012509:Sarcoma / Q000175:diagnosis* / Q000473:pathology
D014408:Biomarkers, Tumor