title: Malignant fibrous histiocytoma of the urinary bladder as a post-radiation secondary cancer: a case report.
abstract: BACKGROUND
  Malignant fibrous histiocytomas have been periodically reported as the primary tumor in various organs including the urinary bladder, and is the second most frequent sarcoma of the urinary tract in adults. This report discusses a case of the well established diagnosis of a malignant fibrous histiocytoma of the bladder occurring as a post-radiation cancer after the treatment of a cervical carcinoma. Our findings support those of many previous studies and make the view of the nature of the disease clearer.
  
  
  METHODS
  We report the case of a 54-year-old Thai woman who had been treated with radiation therapy for cervical cancer, who presented to our facility with urinary incontinence. Initially, our patient was diagnosed as having a high-grade urothelial carcinoma. Subsequent radical surgery rendered the final pathological diagnosis, confirmed histologically and immunohistochemically as malignant fibrous histiocytoma, with clinical and pathological staging of T4b N0 M0. Adjuvant chemotherapy was provided for our patient.
  
  
  CONCLUSIONS
  This type of malignancy is very aggressive and easily misdiagnosed due to its rarity. Therefore, in a patient with a prior history of irradiation in the pelvic area, this should be considered as a differential diagnosis to ensure early correct diagnosis and treatment.
authors.affiliation: Department of Pathology, Phramongkutklao College of Medicine, 315 Ratchawithi Road, Thung Phayathai, Ratchathewi, Bangkok 10400, Thailand. thirayost@gmail.com.
authors.forename: Thirayost
authors.initials: T
authors.lastname: Nimmanon
authors.forename: Poonkiat
authors.initials: P
authors.lastname: Ruengpoka
references.citation: Acta Orthop Scand Suppl. 1994 Jun;259:1-31
references.pmid: 8042499
references.citation: Actas Urol Esp. 2000 Jul-Aug;24(7):581-3
references.pmid: 11011450
references.citation: Urol Int. 1999;62(3):164-70
references.pmid: 10529668
references.citation: Actas Urol Esp. 2010 Apr;34(4):378-85
references.pmid: 20470701
references.citation: Eur J Cancer. 1998 Dec;34(13):2068-75
references.pmid: 10070313
references.citation: Pathol Res Pract. 1994 Apr;190(4):311-32
references.pmid: 8078801
references.citation: Indian J Urol. 2007 Jan;23(1):72-4
references.pmid: 19675769
references.citation: Prog Urol. 1997 Apr;7(2):270-2
references.pmid: 9264771
references.citation: Urol Int. 2011;86(3):261-8
references.pmid: 21266796