Malignant fibrous histiocytoma of the scalp. Multidisciplinary treatment

Background Malignant fibrous histiocytomas (MFH) are uncommon in the skin, and even less frequent on the scalp. On the scalp they are often very diffi cult to excise and it is even more difficult to close the resulting wound, Objective To review all malignant fibrous histiocytomas diagnosed and treat ed in our Department during the past 6 years, and to describe the multidisc iplinary procedure employed to treat one special case of aggressive maligna nt fibrous histiocytoma on the scalp that recurred twice. Result Malignant fibrous histiocytomas represent 0.01% of malignant cutaneo us tumors in our area. The immediate results after a multidisciplinary trea tment performed on a recurrent malignant fibrous histiocytoma located on th e scalp were excellent, but recurrence was observed 6 months later. Two yea rs later we have also treated another case of MFH on the scalp. The same su rgical technique was performed, but the patient received high-dose-methotre xate-based neoadjuvant chemotherapy (HD-MTX). One year later, this patient is still alive and no signs of recurrence have been detected. Conclusion When malignant fibrous histiocytoma occurs on the scalp it must be treated immediately by means of an excision with a large peripheral edge of 2 cm from the visual or CAT limits of the lesion, since the first treat ment must be definitive. (C) 1999 Elsevier Science B.V. All rights reserved .