Malignant fibrous histiocytoma

Malignant fibrous histiocytoma (MFH) is a type of cancer that is the most common soft tissue sarcoma of late adult life, most commonly occurring between age 50-70. In rare cases MFH does occur in children, but it is usually in a less aggressive form. However, malignant tumors have occurred in children as young as 13. It occurs more often in caucasians than those of African or Asian descent. Its male:female predominance is 2:1.

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Presentation

MFH occurs most commonly in the extremities and retroperitoneum, but has been reported in many other sites (lung, head/neck, etc.). Development of metastasis depends on the tumor's subtype. Metastasis occurs most frequently in the lung (90%), bone (8%) and liver (1%). In the extremities, it presents as a painless enlarging soft tissue mass. It can develop anywhere in the soft tissue, but also occurs at sites of previous radiation treatment, shrapnel implantation or next to prostheses.

It can be divided into two subtypes: "spindle cell" and "pleomorphic".^[1]

Diagnosis

It can be detected by magnetic resonance imaging (MRI), but a biopsy is required for definitive diagnosis.

Treatment

Treatment consists of surgical removal (the extent of which ranges from tumor excision to limb amputation depending on the tumor) and in some cases chemotherapy.

Prognosis

Prognosis depends on the primary tumor size and grade (aggressiveness). 5-year survival ranges from 35-60%.

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