Malignant Fibrous Histiocytoma of the Ankle: A Case Report

Abstract

Malignant fibrous histiocytomas are a rare soft tissue sarcoma that present as indolent tumors in adults. Treatment consists of wide surgical excision. Local recurrence and metastasis is common and patients must be followed for such. We describe the case of a 49 year-old male that presented with a painless “lump” on the front of his ankle. Magnetic resonance imaging showed a 2.6 x 3.5 x 4.3 cm lesion that displayed high intensity on the T2 weighted image. The mass partially encased the tibialis anterior tendon along the medial aspect without invading the body of the tendon. The radiologist suspected a possible malignant neoplasm including synovial sarcoma or giant cell tumor of the tendon sheath. The patient underwent wide excision of the lesion and pathology diagnosed it as malignant fibrous histiocytoma at the anterior ankle. The patient underwent limb sparing surgery without adjuvant chemotherapy and after 2 years of follow-up he has had no recurrence or metastasis.