A case of malignant fibrous histiocytoma of a hand carpal bone is reported in a 37-year-old male. This represents the first reported case of malignant fibrous histiocytoma at this site.
The patient complained of right wrist discomfort or dull pain of two years duration. X-rays were read as showing well defined osteolytic lesion with marginal sclerosis of the lunate. A diagnosis of intraosseous ganglion was made and it was treated by curettage and bone graft. However, the lesion showed no evidence of ganglion. Histologic examination of the tissue obtained revealed dense aggregates of atypical cells suggestive of metastatic carcinoma. Reevaluation including immunohistological studies concluded the tumor to be a variant of malignant fibrous histiocytoma. He was treated by amputation of the distal forearm and started on chemotherapy with the following scheme: cyclophosphamide 500mg/m2 on day 1 of each cycle; adriamycin 50mg/m2 on day 1; DTIC 200mg/m2 on days 1, 2, 3, 4 and 5. Cycles were repeated every 4 weeks lasting 6 months. The patient is free of disease for ten months.
