Fatal case of metastatic cellular fibrous histiocytoma: case report and review of literature.
BACKGROUND
Cellular fibrous histiocytoma was first described in 1994 as a distinct variant of fibrous histiocytoma. Since then, at least 21 cases of cellular fibrous histiocytomas metastasizing to regional lymph nodes and/or lungs have been described, though not all fatal.


METHODS
We report the case of a 68-year-old male patient who presented with a large ulcerated skin tumor on the left thigh. The lesion was urgently excised. Histopathological examination led to the diagnosis of cellular fibrous histiocytoma. Nine months later, the patient presented with progressive dyspnea. A thoracoabdominal computed tomography revealed diffusely spread nodular lung lesions. A lung biopsy confirmed them to be metastases of the cellular fibrous histiocytoma. The condition of the patient quickly deteriorated, and he deceased 2 months later.


CONCLUSIONS
Given the possible aggressive nature of cellular type of fibrous histiocytoma, we advice complete excision and clinical follow-up. Chest x-rays and ultrasound examination of regional lymph nodes should be performed in atypical lesions.
*Department of Dermatology, ZorgSaam Hospital, Terneuzen, The Netherlands; †Department of Dermatology, University Hospital Ghent, Belgium; ‡Department of Pathology, ZorgSaam Hospital, Terneuzen, The Netherlands; and §Department of Respiratory Medicine, ZorgSaam Hospital, Terneuzen, The Netherlands.
Evelyne
E
Lodewick
Annelies
A
Avermaete
Willem A M
WA
Blom
Bart
B
Lelie
Ronald
R
Block
Marie
M
Keuppens
D000368:Aged; D017809:Fatal Outcome; D051677:Histiocytoma, Malignant Fibrous / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male