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Repeated Unplanned Excision of Malignant Fibrous Histiocytoma (Malignant Fibrous Histiocytoma Misdiagnosed as the Simple Cyst): A Case Report

악성 섬유성 조직구종의 반복된 무계획적 절제(단순 낭종으로 오인된 악성 섬유성 조직구종): 증례 보고

  • Soh, Jae-Wan (Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Woo-Jong (Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Chang-Hyun (Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital) ;
  • Kwon, Sei-Won (Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Han-Jo (Department of Internal Medicine, Hemato-Oncology, Soonchunhyang University Cheonan Hospital)
  • 소재완 (순천향대학교 천안병원 정형외과) ;
  • 김우종 (순천향대학교 천안병원 정형외과) ;
  • 김창현 (순천향대학교 천안병원 정형외과) ;
  • 권세원 (순천향대학교 천안병원 정형외과) ;
  • 김한조 (순천향대학교 천안병원 혈액종양내과)
  • Received : 2012.10.27
  • Accepted : 2012.11.13
  • Published : 2012.12.31

Abstract

A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.

73세 남자환자가 내원 8개월 전 좌측 원위 대퇴부의 연부 조직 종괴로 타 병원에서 절제술을 시행받은 뒤, 재발하여 4개월 뒤 재수술을 받았으나, 수술 부위의 치유되지 않는 창상을 주소로 내원하였다. 타 병원에서 시행한 조직 검사 소견은 단순 낭종이었다. 수술 소견상 종괴는 외측 광근의 근막층을 침범하면서 경계가 불규칙하며 주변으로 유착되어 있어, 종괴로부터 5 cm 경계를 확보하여 단순 절제술을 시행하였다. 본원 조직검사 결과, 악성 섬유성 조직구종으로 진단되어 추가적인 방사선 치료를 시행하였다. 수술 후 1년째까지, 크기가 증가되거나 타 부위에 전이되는 소견은 관찰되지 않았다. 단순 낭종으로 생각하고 절제술을 시행하였으나, 악성 섬유성 조직구종으로 확진되었던 경우로, 종양 절제술은 수술 전 세밀한 검사 및 진단이 필요할 것으로 사료된다.

Keywords

References

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