Malignant fibrous histiocytoma metastases to the small intestine and colon presenting as an intussusception

A case of malignant fibrous histiocytoma metastases to the small intestine and colon presenting as an intussusception is described. Although malignant fibrous histiocytoma is the most common soft tissue sarcoma in late adult life, GI involvement has rarely been reported. The review of both our case and eight cases in the English-language literature suggests that GI involvement from malignant fibrous histiocytoma occurs most frequently in the small intestine (six of nine) and that two major clinical manifestations of GI involvement are GI bleeding (five of nine) from ulcerated tumors and intussusception (two of nine) led by polypoid tumors.     

Viral hepatitis A, E and their mix (A+E) in children

Atypical ("pseudosarcomatous"), cutaneous, fibrous histiocytoma is a rare connective tissue tumor arising on the trunk and limbs in young adults. Its histological diagnosis is difficult. We report the case of a 25-year-old woman who presented a nodule on her left leg. Two years after an incomplete excision, she developed a large local recurrence. Additional radiotherapy, after total reexcision was performed. This treatment was successful and no further recurrence occurred. Clinicopathological features of atypical ("pseudosarcomatous"), cutaneous, fibrous histiocytoma are reviewed. Differential diagnoses, including atypical fibroxanthoma, angiomatoid fibrous malignant histiocytoma and aneurysmal fibrous histiocytoma are discussed.     

The classification of pneumothorax]

We report a case of spontaneous rupture of malignant fibrous histiocytoma. A 50-year-old male with right flank pain was referred to our hospital. Computed tomography (CT) showed a heterogeneous space-occupying lesion on the upper pole of the right kidney. Selective right renal arteriography revealed a hypovascular mass. Preoperative clinical diagnosis was spontaneous rupture of renal cell carcinoma. Radical nephrectomy was performed. Histopathological diagnosis was malignant fibrous histiocytoma arising from the renal capsule.     

Resection of malignant fibrous histiocytoma invading the thoracic aorta

We report a case of surgically resected malignant fibrous histiocytoma which arose in the posterior mediastinum. Tumor removal with the required sufficient-margin and the resection of the affected thoracic aorta, led to flaccid paraplegia below the tenth thoracic level. This patient is now surviving with no evidence of recurrence at 42 months after the operation. Although malignant fibrous histiocytoma in the thorax generally shows a poor prognosis, this patient with complete resection could have a relatively long survival.     

Congenital diaphragmatic hernia: an unsolved problem

Primary and metastatic malignant fibrous histiocytoma of the alimentary tract is uncommon, even though it is the most frequently diagnosed malignant soft tissue tumor in adults. In this report, we describe a case of malignant fibrous histiocytoma of the colon.     

Spirituality: an important aspect of emergency nursing

Fibrous histiocytoma has a variable, unpredictable behaviour and potential for malignancy. The treatment of choice is wide local excision, which, in the larynx, entails total laryngectomy. A case of fibrous histiocytoma of the larynx, treated successfully by radiotherapy, is presented. A recurrence was treated with cryosurgery and the patient is well at 10-year follow-up. The pathological characteristics of fibrous histiocytoma and the difficulties of classification are reviewed.     

Malignant histiocytofibroma. Apropos of 3 cases of cervicofacial localization

We report 3 cases of head and neck malignant fibrous histiocytoma (MFH). The first case is a xanthomatous subtype of the inferior lip with lymph node metastasis. The two others cases are storiform-pleomorphic MFM of the hypopharynx and Killian area. A summary of actual knowledges about this entity is reviewed.     

Angiosarcomas associated with bone infarcts

OBJECTIVE: A bone infarct may occasionally dedifferentiate to osteogenic sarcoma, fibrosarcoma or malignant fibrous histiocytoma. However, the association of an angiosarcoma with a bone infarct is extremely rare. Such an association is presented in three patients. Their clinical course is compared with that of patients with bone infarcts associated with other sarcomas. DESIGN AND PATIENTS: The three patients were men with a mean age of 43 years. Cases 1 and 3 presented with a pathological fracture at the site of the angiosarcoma. Plain radiography was done in the three patients, computed tomography (CT) was performed in cases 1 and 3 and magnetic resonance imaging (MRI) in case 3. The femur was the site of the three tumors: midshaft in cases 1 and 3 and distal shaft in case 2. On the basis of the radiographic findings, and clinical examination, an open biopsy was performed for the three men, which confirmed the diagnosis of a high-grade angiosarcoma associated with a bone infarct. RESULTS: Case 1 was treated with high-above knee amputation and is still alive after 18 months from the time of operation. Segmental resection of the distal femur with adjuvant chemotherapy and local irradiation was the treatment for case 2, who is still alive with no tumor recurrence on metastatic disease 3 years from the operation. Intramedullary rodding was done for case 3 who died 6 months later. CONCLUSION: The association of an angiosarcoma with a bone infarct has been established in only five cases. Although the number of such associations is small, it seems that such an association may be prognostically more or less the same as in those cases in which a bone infarct is associated with either osteosarcoma, fibrosarcoma or malignant fibrous histiocytoma, where the survival rate is unfavorable. A cause-and-effect relationship may exist between a bone infarct and subsequent development of a bone sarcoma.     

Primary meningeal malignant fibrous histiocytoma with cerebrospinal dissemination and pulmonary metastasis

Primary intracranial malignant fibrous histiocytoma (MFH) is very rare, and not much is known about its clinical features. The authors report a case of left temporal leptomeningeal MFH, with consequent cerebrospinal fluid (CSF) dissemination and pulmonary metastasis. The clinical features of this case and the therapeutic prognosis of 17 cases reported previously in the literature were reviewed.     

Adverse reactions associated with autologous blood transfusion: evaluation and incidence at a large academic hospital

Malignant fibrous histiocytoma (MFH) in the stomach is very rare, and only four cases have been reported. As a result, there is still little understanding of its clinical and pathological features. We recently experienced two cases of gastric MFH. The first case was a 78-year-old man with epigastralgia and a loss of body weight. Endoscopy revealed an ulcerated submucosal tumor. A gastrectomy was performed and the diagnosis of MFH was made histopathologically. The second case was a 77-year-old man with pulmonary symptoms. An image diagnosis indicated a strong suspicion of lung cancer, and a right middle and lower lobectomy was thus performed. One month after the operation, a bleeding gastric tumor was found and therefore a gastrectomy was performed. Both tumors were diagnosed as MFH. From the analysis of six reported cases including ours, a preoperative correct diagnosis is found to be difficult although the lesion has grown to a considerable size at the time of operation. Since a metastatic lung lesion was first detected in two out of six cases, it is thus recommended that the stomach should be examined when lung MFH is found. Considering the high mortality and the short survival in the six cases, the prognosis for gastric MFH seems to be poorer than that in the extremities. However, lymph node metastasis is uncommon, and a curative resection is possible in some cases such as in our second case.     

Benign fibrous histiocytoma of the nasal cavity in a newborn: MR and CT findings

Benign fibrous histiocytoma of the nasal cavity in a newborn is rare, and the MR imaging appearance of this entity has not been reported. We present the MR and CT findings in such a case and review the differential diagnosis for intranasal masses in the neonate.     

Primary malignant fibrous histiocytoma of spleen

We report a case of primary malignant fibrous histiocytoma of spleen, which also emphasizes the difficulties in diagnosing such a rare condition.     

LN-2 (CD74). A marker to distinguish atypical fibroxanthoma from malignant fibrous histiocytoma

BACKGROUND: In this study, the authors examined the expression of LN-2, an antigen expressed by B cells, macrophages, and Reed-Sternberg cells, in a variety of spindle cell lesions of the skin to determine whether LN-2 immunoreactivity can be used to differentiate among these tumors. For comparison, they examined CD34 antigen expression in these lesions, which has been shown to be a useful marker in differentiating dermatofibrosarcoma protuberans from dermatofibroma. METHODS: Immunocytochemistry with anti-LN-2 and anti-CD34 monoclonal antibodies on formalin fixed, paraffin embedded material was performed on 102 spindle cell lesions, including dermatofibroma, dermatofibrosarcoma protuberans, atypical fibroxanthoma, malignant fibrous histiocytoma, leiomyoma, and neurofibroma. RESULTS: LN-2 immunoreactivity did not distinguish between dermatofibroma and dermatofibrosarcoma protuberans, both of which showed weak immunoreactivity. In marked contrast, 90% of cases of malignant fibrous histiocytoma showed strong staining for LN-2, whereas the vast majority (90%) of cases of atypical fibroxanthoma were negative or stained only weakly with anti-LN-2 antibodies. Of the two cases of atypical fibroxanthoma that stained strongly for LN-2, both lesions were > 2 cm in size and extended deep into the subcutaneous fat. CONCLUSIONS: Differential expression of the LN-2 antigen by atypical fibroxanthoma and malignant fibrous histiocytoma distinguishes these two lesions and suggests that acquisition of LN-2 positivity may be a marker of tumor progression.     

Dermal and intravascular fasciitis. Unusual variants of nodular fasciitis

Three cases with characteristic features of nodular (pseudosarcomatous) fasciitis arising in the dermis are described. This is only the second report documenting a dermal location for this condition. One of the three cases also showed features of intravascular fasciitis. A fourth case of intravascular fasciitis arising in periocular tissue is included. The differential diagnosis of dermal fasciitis includes benign fibrous histiocytoma, pyogenic granuloma, peripheral nerve tumors, cutaneous smooth muscle tumours, spindle cell carcinoma, spindle cell melanoma, dermatofibrosarcoma protuberans and atypical fibroxanthoma.     

Malignant fibrous histiocytoma of the gallbladder

We report two extremely rare cases of primary malignant fibrous histiocytoma (MFH) of the gallbladder. The first case occurred in a 70 year old woman who presented with a large tumor of the gallbladder and multiple liver metastases. The second case involved a 74 year old man with a small submucosal tumor of the gallbladder and a single large liver metastasis. Histologically, these tumors consisted of spindle cells in a storiform pattern intermingled with bizarre giant cells. Both of these patients died of liver failure 3 months post-operatively.     

Serial sonographic changes in a case of isthmic pregnancy treated with methotrexate

A case report of a primary malignant fibrous histiocytoma (MFH) in the mandible of a young adult male is presented and relevant literature reviewed. The clinical presentation and course of the case is typical of MFH of the jaw as reported in the literature.     

A case of primary fibrous histiocytoma of the lung

Fibrous histiocytoma is non-epithelial malignant tumor mainly arising from soft tissue in extremities and body. Those derived from lung are rare. A 71-year-old female was admitted to our hospital because of an abnormal shadow on chest X-ray film. Preoperative diagnosis was not obtained by various examination. The tumor was located in right upper lobe (S2) and partial resection of right upper lobe was performed. Pathological diagnosis was fibrous histiocytoma of borderline malignancy. After the operation, adjuvant therapy was not done. The patient is doing well without recurrence and metastasis, during 4 years after the operation. However, careful follow-up should be necessary for long term.     

Malignant fibrous histiocytoma of the breast. A clinical case

The authors report a personal, observed case of relapsing malignant fibrous histiocytoma of the breast. After recalling the anatomopathologic aspects and the clinical characteristics of the affection, the authors dwell upon the utility of correct diagnosis and point to the right therapeutic way consisting of a radical surgical treatment.     

Single somatic ras gene point mutation in soft tissue malignant fibrous histiocytomas

The frequency of ras gene mutations in human soft tissue malignant fibrous histiocytomas within and around the hot spot codons (12, 13, and 61) of all ras genes, (H-ras-1, K-ras-2, and N-ras) was studied by nested polymerase chain reaction and direct DNA sequencing from archival formalin-fixed, paraffin-embedded tissue. Light microscopy and immunohistochemistry served to define malignant fibrous histiocytoma. All of the four differentiation subtypes (storiform-pleomorphic, inflammatory, myxoid, and giant cell) were investigated. Nine of thirty-two malignant fibrous histiocytomas (28%) contained ras gene point mutations. The highest incidence was found in the myxoid subtype (four of nine). H-ras-1 gene codon 12.2 was the only codon affected and contained in all mutated cases a GGC-->GTC exchange. Seven of the nine mutations were homozygous and probably affected more than 80% of the tumor DNA. The flanking regions of all hotspot codons did not contain any point mutation. The presence of a single and often homozygous point mutation of the H-ras-1 gene, especially in myxoid malignant fibrous histiocytoma could serve as a basis for further genomic discrimination of myxoid sarcomas.     

Fibrous dysplasia of the spine, costae and hemipelvis with sarcomatous transformation

We describe a patient with polyostotic fibrous dysplasia and secondary malignant fibrous histiocytoma in a spinal lesion.