Malignant fibrous histiocytoma of paratesticular region in a 68 -year-old man: presenting a rare case report

Malignant fibrous histiocytoma (MFH) is a rare neoplasm of the scrotal region. We haven’t so much information about pathophysiology of this malignancy. There are four histological subtypes of MFH: myxoid, storiform-pleomorphic, inflammatory and giant cell. The storiform-pleomorphic type is the most common. We report a case of a 68 year-old man with a history of 7 months mass in his right inguinal region. Recently the mass became larger in size and took the entire scrotum. Physical examination revealed swelling and tenderness on this area. The ultrasound study showed an extreme hydrocele with a 20*13*9 cm mass in the right inguinal region that extended to scrotum but didn’t involve the orchid. Incisional biopsy of the mass was performed and microscopic examination reported highly pleomorphic spindle cells arranged in a storiform pattern along with areas of necrosis Diagnose was malignant fibrous histiocytoma (MFH) storiform-pleomorphic (SP) type. According to the TNM and American Joint Committee on Cancer sarcoma staging system, the neoplasm was grade III sarcoma. The patient underwent radical right orchiectomy, dissection of ileo femoral lymph nodes and systemic chemotherapy.The management of MFH is explained with other sarcomas, but these tumors have a high rate of recurrence that may be accompanied by an increased malignant potential and it could be a risk marker for distant failure.

Keywords:

Malignant fibrous histiocytoma , storiform-pleomorphic , inguinal mass