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CORRESPONDENCE |
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| Year : 2022 | Volume
: 67
| Issue : 6 | Page : 824-825 |
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| Malignant fibrous histiocytoma of scalp after repeated infection |
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Yangzong Wu1, Penghui Liu2, Yuanfeng Chen1, Xiaopin Chen3, Yuanxiang Lin2
1 From the Department of Neurosurgery, Longyan Second Hospital of Fujian Province, Fujian Province, P. R. China
2 Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fujian Province; Department of Neurosurgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian, P. R. China
3 Department of Pathology, Longyan Second Hospital of Fujian Province, P. R. China
| Date of Web Publication | 23-Feb-2023 |
Correspondence Address:
Yangzong Wu
Department of Neurosurgery, Longyan Second Hospital of Fujian Province, Fujian Province
P. R. China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijd.ijd_267_22
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How to cite this article:
Wu Y, Liu P, Chen Y, Chen X, Lin Y. Malignant fibrous histiocytoma of scalp after repeated infection. Indian J Dermatol 2022;67:824-5 |
How to cite this URL:
Wu Y, Liu P, Chen Y, Chen X, Lin Y. Malignant fibrous histiocytoma of scalp after repeated infection. Indian J Dermatol [serial online] 2022 [cited 2023 Mar 29];67:824-5. Available from: https://www.e-ijd.org/text.asp?2022/67/6/824/370284 |
Sir,
A 73-year-old Chinese man presented with a 2-month history of partial lesion swelling and enlargement on the scalp. He had a medical history of scalp injury caused by trauma a year ago and the wound was left untreated. The wound on the scalp represented repeated oozing and infection during the period. Two months ago, the wound had a partial lesion swelling and enlargement, the swelling gradually increased in size and bled easily when touched. Clinically, the lesion presented as a 'red mushroom' appearance, and the maximum diameter of the tumour was 5.0 cm [Figure 1]. During the operation, it was clear that the tumour invaded the skull. Hence, the patient underwent subcutaneous tumour ectomy with partial craniectomy. HE staining represents the diagnosis of malignant fibrous histiocytoma (MFH) [Figure 2]a, [Figure 2]b, [Figure 2]c, [Figure 2]d. Immunohistochemical staining showed CD68 (+), Ki-67 (50% +), p63 (+), vimentin (+), ck5/6 (−), which represented the diagnosis of MFH [Figure 2]e, [Figure 2]f, [Figure 2]g, [Figure 2]h. | Figure 1: Scalp condition of patients. (a) Preoperative presentation of the lesion on the scalp. (b) Tumour specimen and surrounding scalp. (c) Intraoperative macroscopic view. (d) Postoperative presentation of the scalp
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 | Figure 2: Postoperative pathological HE staining and immunohistochemical staining. (a-d) HE staining represents the diagnosis of MFH. (e) Immunohistochemical staining showed CD68 (+). (f) Immunohistochemical staining showed Ki-67 (50% +). (g) Immunohistochemical staining showed p63 (+). (h) Immunohistochemical staining showed vimentin (+)
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Inflammation plays a crucial role in carcinogenesis and tumour progression, and chronic inflammation induces the development of various cancers.[1] Similarly, inflammatory responses may also play a crucial role in the pathogenesis of MFH. In the present study, the patient had a medical history of scalp injury caused by trauma a year ago and the wound was left untreated. The wound on the scalp represented repeated oozing and infection during the period. Under long-term inflammation stimulation, RNS and ROS are generated from infiltrated inflammatory cells, which are considered to cause DNA damage and the following pathogenesis of inflammation-related cancer.[2] Hoki et al.[3] indicated that chronic inflammation caused iNOS-dependent DNA damage, which participated in not only the initiation and promotion of MFH but also in the progression of MFH. 8-nitroguanine is a mutagenic nitrative DNA lesion for med during chronic inflammation.[4] In this study, 8-nitroguanine was colocalized with iNOS and NF-kB in tumour cells of MFH patients. NF-kB expression in the nucleus of tumour cells was closely correlated with iNOS expression in MFH patients. Hence, they hypothesised that 8-nitroguanine formation is dependent on iNOS expression mediated by NF-kB activation. These above-mentioned contents were in accordance with our conjecture that the scalp wound with repeated oozing and infection caused long-term inflammation, which led to carcinogenesis.
The present case report demonstrates that inflammation may play a vital role in the initiation and promotion of MFH. Aggressive surgical therapy is essential for the management of MFH. To our knowledge, this is the first reported case of long-term infection-induced MFH.
Financial support and sponsorship
This study was supported by the Longyan Science and Technology Project of Fujian Province (No. 2019LYF12009, principal investigator: Yangzong Wu) grant from the Longyan Science and Technology Bureau.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Coussens LM, Werb Z. Inflammation and cancer. Nature 2002;420;860-7.  |
| 2. | Hussain SP, Hofseth LJ, Harris CC. Radical causes of cancer. Nat Rev Cancer 2003;3;276-85. |
| 3. | Hoki Y, Hiraku Y, Ma N, Murata M, Matsumine A, Nagahama M, et al. iNOS-dependent DNA damage in patients with malignant fibrous histiocytoma in relation to prognosis. Cancer Sci 2007;98;163-8. |
| 4. | Hoki Y, Murata M, Hiraku Y, Ma N, Matsumine A, Uchida A, et al. 8-Nitroguanine as a potential biomarker for progression of malignant fibrous histiocytoma, a model of inflammation-related cancer. Oncol Rep 2007;18;1165-9. |
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