The authors have indicated no significant interest with commercial supporters.
The Evolving Conception and Management Challenges of Malignant Fibrous Histiocytoma
Article first published online: 9 AUG 2012
© 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.
Volume 38, Issue 12, pages 1922–1929, December 2012
How to Cite
Hollmig, S. T., Kirkland, E. B., Henderson, M. T., Tang, J. Y. and Gladstone, H. B. (2012), The Evolving Conception and Management Challenges of Malignant Fibrous Histiocytoma. Dermatologic Surgery, 38: 1922–1929. doi: 10.1111/j.1524-4725.2012.02538.x
- Issue published online: 3 DEC 2012
- Article first published online: 9 AUG 2012
Malignant fibrous histiocytoma (MFH) is a rare and aggressive tumor. Mohs micrographic surgery (MMS) has been reported as an effective treatment, although most cases were published before advances in cytopathologic techniques led to reclassification of many tumors.
To evaluate a contemporary cohort of individuals with MFH and analyze management practices.
We reviewed all cases of MFH diagnosed at our institution from January 1995 to December 2010, evaluating 839 records to identify 36 patients undergoing management of tumors of the head and neck.
Seventeen of the total 36 patients (47%; mean age 67) experienced tumor recurrence, and 10 (28%) developed metastases. Seven of nine patients initially treated with MMS (78%), and 10 of 24 (42%) treated with WLE experienced recurrence (p = .06). Patients treated with MMS had smaller tissue defects after surgery. The mean contemporary recurrence rate of MFH treated with MMS is significantly higher (58.8%) than the cumulative recurrence rate reported before 2000 (7.4%) (p < .001).
Our study is consistent with reports of MFH as an aggressive neoplasm and describes the largest population treated with MMS in 3 decades. The changing conception of MFH, along with a propensity for in-transit metastases, may explain higher contemporary recurrence rates.