Benign Fibrous Histiocytoma of the Pterygopalatine Fossa with Intracranial Extension

A very rare case of fibrous histiocytoma arising in the pterygopalatine fossa with intracranial extension is described. Despite the histologic absence of nuclear pleomorphism, the tumor rapidly recurred after complete surgical resection. The patient, a 45 year old male, died shortly thereafter. The aggressive nature of our patient's tumor confirms previous observations that an aggressive radiographic appearance has prognostic value when dealing with skeletal and soft tissue tumors. The benefit of multimodal therapy has not been established in these rare head and neck lesions. In the subset of fibrous histiocytomas that invade bone, however adjunctive treatment with radiation and or chemotherapy may be appropriate.