A Malignant Fibrous Histiocytoma After Radical Mastectomy With Radiotherapy -a Case Report-

A rare case of radiation induced malignant fibrous histiocytoma is presented. A 57-year-old woman noticed a rapidly enlarging tumor with itch in the left supraclavicular region and visited another hospital. There was a previous history of undergoing a radical mastectomy with radiotherapy for a left breast cancer at elsewhere (no clear information on clinical stage and dose of radiation was obtained). The patient was referred to the hospital. On admission a 10×8cm tumor in the left supraclavicular region was noted. The tumor had lobulated surface to bleed easiles and fixed to the clavicle. Thoracic CT and MRI revealed a hypervascular tumor destroying the clavicle. Angiography showed keterogenous vascularity of the tumor vis the transverse and ascending cervical arteries. We carried out wide resection of the tumor with the clavicle and reconstructed with a left lattisimus dorsi flap. Since the tumor was composed of atypical fibroblasts and histiocytes. It was diagnosed as radiation induced malignant fibrous histiocytoma. After operation, inflammation of the flap and dyskinesia of the left upper extremity occurred, but were managed conservatively. There has been no sign of recurrence as of 2 years and 8 months after the operation.