Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7930-7936
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7930
Malignant fibrous histiocytoma of the bone in a traumatic amputation stump: A case report and review of the literature
Ke-Yang Zhao, Xu Yan, Peng-Fei Yao, Jiong Mei
Ke-Yang Zhao, Xu Yan, Jiong Mei, Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
Peng-Fei Yao, Department of Orthopedics, Huainan First People's Hospital, Huainan 200233, Anhui Province, China
Author contributions: Zhao KY contributed to the paper writing; Yan X and Yao PF contributed to the data collection; Mei J contributed to the idea conception, manuscript editing, and approval for submission.
Informed consent statement: Written informed consent was obtained from the patient to have the case details and any accompanying images published.
Conflict-of-interest statement: None of the authors have financial conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiong Mei, MD, Chief Doctor, Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Xuhui District, Shanghai 200233, China. meijiong@sjtu.edu.cn
Received: April 19, 2021
Peer-review started: April 19, 2021
First decision: May 24, 2021
Revised: June 1, 2021
Accepted: July 22, 2021
Article in press: July 22, 2021
Published online: September 16, 2021
Processing time: 143 Days and 17.7 Hours
Abstract
BACKGROUND

Malignant fibrous histiocytoma (MFH) is one of the most common soft tissue sarcomas among adults. It is characterized by large size, high grade, and biological aggressiveness. There are many reports of MFH after local stimulation, such as bone fracture, implants, and chronic osteomyelitis. In this paper, we report a patient who developed MFH 6 years after amputation, suggesting that wound healing and mechanical force play a role in the local stimulation of this disease.

CASE SUMMARY

A 66-year-old man complained of persistent pain in his residual mid-thigh. He had undergone amputation surgery due to a traffic accident 6 years prior. Physical examination showed tenderness but no abnormalities in appearance. X-ray radiographs and magnetic resonance imaging supported the diagnosis of a tumor, and a biopsy confirmed that the lesion was MFH. The patient received neoadjuvant chemotherapy and left hip disarticulation. During the 6-mo follow-up, there were no symptoms of recurrence.

CONCLUSION

Postsurgery MFH has been reported before, and many studies have attributed it to the biological effects of implants. Our case report shows that this disease can develop without an implant and thus highlights the importance of local stimulation. The wound-healing process and mechanical force can both promote this tumor, but whether they directly cause MFH needs further investigation.

Keywords: Malignant fibrous histiocytoma; Postamputation pain; Traumatic amputation; Case report

Core Tip: In this paper, we report a patient who developed malignant fibrous histiocytoma 6 years after amputation, suggesting the role of wound-healing and mechanical force as local stimulation in this disease.