Primitive malignant fibrous histiocytoma of the neck with carotid occlusion and multiple cerebral ischemic lesions.

Abstract

Emergence of a malignant tumor at the site of an operation is a rare event and most often arises in association with retained foreign material. We describe a patient who 1 year after a left carotid endarterectomy for typical atheromatous lesions presented with several transient ischemic attacks with stepwise worsening of the deficit and rapid death. A few weeks before, a tumor of the neck had appeared at the site of the previous endarterectomy. At postmortem examination, we found a malignant histiocytofibroma occluding the left carotid artery, with several recent ischemic foci in the corresponding cerebral hemisphere without metastasis or tumor emboli. This observation is unusual owing to the histological type of the neoplasm and to the circumstance of emergence of the neoplasm.