Abstract

We reported a case of 67-year-old man with malignant fibrous histiocytoma (MFH). He noticed a subcutaneous tumor on the right lateral lower leg three years ago. Tumor was totally excised by a primary physician about two years ago, and histological examination revealed the tumor to be MFH. The lesion recurred one year ago and he presented us on february 24, 1994. Physical examination revealed 45×45mm, well-demarcated, elastic hard, subcutaneous tumor with pain. A detailed evaluation showed no evidence of metastatic disease, however a invasion to the peroneus muscle was suggested. Surgical resection of the tumor was carried out along clinically 3cm normal skin margin, including peroneus longus, brevis and soleus.
Postoperative radiation therapy was performed before the reconstructive surgery for fear of microscopic subclinical residual tumor. The defect was reconstructed with a free LD flap. Two years and six months postoperatively, there has been no sign of recurrence. We think that the free flap transfer is useful for the defect after tumor excision.