Malignant fibrous histiocytoma, now referred to as Undifferentiated Pleomorphic Sarcoma: A Case Report of an unexpected histology of a subcutaneous lesion

INTRODUCTION: An 85 year old male presented to his General Practitioner with a vague history of a lump on his back that was mobile and non tender. He had a previous history of advanced prostate cancer and radiotherapy treatment. PRESENTATION: We present an unexpected diagnosis of malignant fibrous histiocytoma of a subcutaneous lesion removed from the patient’s back. DISCUSSION: Excisions of subcutaneous lesions along with cutaneous lesions form the majority of cases on a usual minor operations list. All lesions are sent for histopathological analysis and most are confirmed benign sebaceous cysts or lipomas. However the entity of malignant fibrous histiocytoma, now referred to as undifferentiated pleomorphic sarcoma (UPS) should be kept in mind. Patients will usually present late with advanced local disease or metastasis, usually to lungs and lymph nodes. Treatment is surgical with wide local excision and neoadjuvant/adjuvant radiotherapy has been advocated as well. CONCLUSION: Undifferentiated pleomorphic sarcoma should be a differential in subcutaneous lesions in older adults with a previous history of malignancy, radiation therapy and a mass in the subcutaneous tissue of the back.