L-TRYPTOPHAN INDUCED EOSINOPHILIA-MYALGIA-SYNDROME ASSOCIATED WITH PRIMARY CUTANEOUS MALIGNANT FIBROUS HISTIOCYTOMA AND EXTRAABDOMINAL DESMOID TUMOR

A 57-year-old woman with L-tryptophan-induced eosinophilia-myalgia syn drome, 23 months after the onset of symptoms, experienced development of a parasternal malignant fibrous histiocytoma on previously sclerode rma-like skin areas and, almost concurrently, an extraabdominal desmoi d tumor of the left arm muscle fascia. The malignant fibrous histiocyt oma was treated by surgical excision without sign of recurrence or met astasis 19 months later. Radiation therapy was performed on the extraa bdominal desmoid tumor. We suspect that these two connective tissue tu mors in this patient were related to the exposure to contaminated L-tr yptophan, which interfered with connective tissue metabolism.