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Malignant Fibrous Histiocytoma Causing Fatal Ileal Perforation

of superficial lesions can occur, which together with the presence of regional nodes may suggest an infective or neoplastic process. Involution has occasionally been described in small lesions, but large lesions invariably persist if left untreated. Although up to 50% of lesions recur after excision or curettage"3, and whilst a unique case ofmicroscopic metastasis has been described7, it is generally felt that a conservative approach is all that is required"2'5. The true nature ofthis lesion has been unclear for a long time. It is now generally thought to be a true neoplasm composed ofproliferating endothelial cells which take on a characteristic plump, epithelioid appearance. The lymphoid and eosinophilic components are considered to be reactive"5. The clinical features of this uncommon lesion are by no means characteristic; indeed Mehregan and Shapiro6 listed ten separate clinical diagnoses for their series of 14 cases. Surgeons should be aware of this interesting entity to avoid unnecessary treatment. Acknowledgments: We are grateful to Mr A W Goode and Dr J van der Walt for their help in preparing this paper.