Myxoid Type of Malignant Fibrous Histiocytoma of the Maxillary Sinus: A Case Report

Document Type : Case Report

Authors

1 Departments of pathology, Mashhad University of Medical Sciences, Mashhad, Iran

2 Ear, Nose, Throat, Head and Neck surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Depatment of endodontics, Faculty of Dentistry and Dental Research Center, Mashhad, University of Medical Sciences, Mashhad, Iran

Abstract

Introduction:
Myxofibrosarcoma was originally described as the myxoid variant of Malignant Fibrous Histiocytoma (MFH), a high-grade and aggressive sarcoma, which is very uncommon in the head and neck region, with about 100 cases reported up to now. MFH occurring in the maxillary sinus is so rare that only 23 cases have been reported. We hereby report a case of myxofibrosarcoma in the maxillary sinus.
Case Report:
The case was a 54-year-old male with symptoms of toothache in the right posterior maxillary teeth, a swelling adjacent to maxillary molar region and symptoms of chronic maxillary sinusitis. In clinical examination, the teeth were sensitive to percussion and palpation, but no caries and restoration was detected on his molar teeth. He was suffering from local pain and tenderness over his midface and mild fever, fatigue and some nonspecific vague pain. CT scan showed a mass lesion involving right nasal cavity, maxillary and ethmoidal sinuses. A low-grade malignancy arising from the right maxillary sinus was highly suspected. A surgery was done to remove the mass. The histological and immunohistochemical studies proved the diagnosis of myxoid variant of Malignant Fibrous Histiocytoma. Therefore radiotherapy and chemotherapy was started for the patient but six months later the symptoms returned and CT scan showed a right maxillary and ethmoidal mass that extended to base of the skull. Maxillectomy and ethmoidectomy were performed for the patient, but 2 months later he died because of the extension of the tumor, which confirmed the necessity of early diagnosis.
Conclusion:
Amplified radical surgery is the first choice of treatment. The second surgery has special value to the recurrent patients. Radiotherapy alone or chemotherapy alone is not effective to MFH of head and neck region

Keywords

References

  1. Weiss SW. Malignant fibrous histiocytoma. A reaffirmation. Am J Surg Pathol 1992; 6: 773-84.
  2. Jin GP, Zhao M, Qi JX, Jiang HG, Yu SG. [Malignant fibrous histiocytoma of head and neck: Clinical analysis of 21 cases]. Ai Zheng 2003; 22(5): 523-5. (Chinese)
  3. Meister P. Malignant fibrous histiocytoma. History, histology and histogenesis. Path Res Pract 1988; 183: 1-7.
  4. Wood GS, Beckstead JH, Turner RR, Hendrickson MR, Kempson RL, Warnke RA. Malignant fibrous histiocytoma turnover cells resemble fibroblasts. Am J Surg Pathol 1986; 10: 323-35.
  5. 5. Chan YW, Guo YC, Tsai TL, Tsay SH, Lin CZ. Malignant fibrous histiocytoma of the maxillary sinus presenting as toothache. Chin Med Assoc 2004; 67(2): 104-7.
  6. Sima AA, Ross RT, Hoag G, Rozdilsky B, Diocee M. Malignant fibrous histiocytomas. Histologic, ultrastructural and immunohistochemical studies of two cases. Can J Neurol Sci 1986; 13: 138-45.
  7. Sato T, Kawabata Y, Morita Y, Noikura T, Mukai H, Kawashima K, et al. Radiographic evaluation of malignant fibrous histiocytoma affecting maxillary alveolar bone: A report of 2 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92(1): 116-23.
  8. Young YH, Hsieh T. [Malignant fibrous histiocytoma of the head and neck: Report of 5 cases]. Taiwan Yi Xue Hui Za Zhi 1989; 88(6): 606-9. (Taiwan)
  9. Guney E, Yigitbasi OG, Balkanli S, Canoz OM. Post irradiation malignant fibrous histiocytoma of the larynx: A case report. Am J Otolaryngol 2002; 23(5): 293-6.
  10. Barnes L, Kanbour A. Malignant fibrous histiocytoma of the head and neck: A report of 12 cases. Arch Otolaryngol Head Neck Surg 1988; ?: 1149-56.
  11. Pellitteri PK, Ferlito A, Bradley PJ, Shaha AR, Rinaldo A. Management of sarcomas of the head and neck in adults. Oral Oncol 2003; 39: 2-12.
  12. Patel SG, Shaha AR, Shah JP. Soft tissue sarcomas of the head and neck: An update. Am J Otolaryngol 2001; 22: 2-18.
Iranian Journal of Otorhinolaryngology
Volume 23, Issue 2 - Serial Number 2
March and April 2011
Pages 43-48

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