Malignant fibrous histiocytoma of maxillary sinus and nasopharyngeal region

Maxilla and nasopharynx are rare sites for malignant fibrous histiocytoma. They are derived from multipotential mesenchymal cells that have the ability to differentiate into two pathways, fibroblastic and/or histiocytic. The tumor has an aggressive behaviour and death usually occurs within 2 years. Two cases of MFH studied at this institution are reported here. In these cases lymphnode metastases occured in one case and recurrence in other case after surgical excision and chemotherapy. The survival period was 10 months in 1st case and in 2nd case it was 1 year 5 months.     

Malignant fibrous histiocytoma of the maxillary sinus. Clinical and therapeutic aspects

Malignant fibrous histiocytomas, or MFH, have been individualized only since the last two decades. These sarcomas which usually develop from soft tissues are no longer considered rare, except in some of their facial sinus localizations. Two chapters will be particularly developed: the paramount significance of anatomopathological investigations owing to the difficulty in establishing the diagnosis, since MFHs may be mistaken for benign processes; the treatment which is, generally speaking, the same as for bone sarcomas.     

Malignant fibrous histiocytoma of the maxillary sinus. Case report and literature review

A case of malignant fibrous histiocytoma of the maxillary sinus, which to our knowledge is the third such report, involved a patient who was seen initially with nasal obstruction, swelling of the face, and visual disturbances. Three months after partial excision of the tumor and radiotherapy and chemotherapy, the patient died of bone and liver metastases. These tumors usually manifest initially with symptoms directly referable to the involved sinus. If there is any evidence of metastatic disease, the prognosis appears to be poor.     

Malignant fibrous histiocytoma of the frontal sinus

The first case of malignant fibrous histiocytoma of the frontal sinus is reported. The aggressive nature of the tumor despite its relatively benign histologic pattern and value of electron microscopy are emphasized. Ultrastructural examination reveals a progression of several principal cell types, lending support to the multi-potent mesenchymal cell origin of these malignancies. These cells may have arisen from the supporting stroma of the ectodermally derived respiratory epithelium of the paranasal sinuses. Wide local excision is currently the primary mode of therapy. The value of radiation therapy or chemotherapy in this tumor in unproven.     

Malignant fibrous histiocytoma in the maxillary sinus. Xanthoma-like change of the tumor after radiotherapy

A case of malignant fibrous histiocytoma (MFH) in the right maxillary sinus is reported. Patient was a 30-year-old male, and was diagnosed as pleomorphic type of MFH by biopsy before therapy. The tumor shrunk and changed into xanthoma-like tumor after radiotherapy. A case like the present case has not been reported previously in the literature.     

Malignant fibrous histiocytoma of ethmoid sinus

Malignant Fibrous Histiocytoma (MFH) is a rare tumour to involve ethmoid sinuses. So far only 7 cases have been reported in the literature to our best of knowledge. The disease predominantly affected younger people with no significant sex prediliction. The aggressive behaviour of the tumour clinically is an important parameter to clinch the malignant nature of the disease. Wide surgical resection is the accepted method of treatment. Local recurrences are frequent and distant metastasis are not known from ethmoid sinus.     

Malignant fibrous histiocytoma of the ethmoid sinus

Malignant fibrous histiocytomas are soft-tissue tumours of histiocytic origin that occur infrequently in the head and neck region. There are no completely reliable histologic criteria for the diagnosis of malignancy. Only five MFHs arising primarily from the ethmoid sinus have been reported in the literature. A further case is described in which the diagnosis was only definitely established following ultrastructural examination. Local tumour recurrence occurred in both the nasal cavity and nasopharynx eighteen months following primary combination treatment by radiotherapy, cytotoxic chemotherapy and surgery. Multicentric synchronous tumour recurrence has not been previously described in MFH involving the head and neck. This feature may account for the well documented high local recurrence rate following apparently complete surgical ablation.     

Malignant fibrous histiocytoma of the larynx.

Malignant fibrous histiocytomas of the upper respiratory tract are rare, aggressive mesenchymal neoplasms. We report a case of a glottic malignant fibrous histiocytoma of the larynx on a 54 year old man. Only a few have been reported in the English literature. The clinical behaviour and degree of malignancy of these tumours cannot be predicted. Wide, aggressive excision of the tumour with a margin of normal tissue appears to be the treatment of choice. About two years after total laryngectomy the patient is well and free of disease.     

Malignant fibrous histiocytoma of the tongue

A case of malignant fibrous histiocytoma, which developed in the tongue of a 16-year-old girl is presented. Surgical excision with, or without, radical neck dissection is the treatment of choice of this type of lesion.     

Malignant fibrous histiocytoma of the nasopharynx

Malignant Fibrous Histiocytomas (MFH) are uncommon in the head and neck and extremely rare in the nasopharynx. We report a case of MFH arising in the nasopharynx and describe its diagnosis and management. The literature is reviewed and the likely origins of the tumour and its behaviour are discussed.     

Malignant fibrous histiocytoma of the larynx

Malignant fibrous histiocytoma of the upper respiratory tract is rare. We report a case of a glottic malignant fibrous histiocytoma in a 46-year-old man. Ultrastructural findings demonstrated that tumor cells were composed of fibroblast-like cells with abundant rough endoplasmic reticulum, histiocyte-like cells with numerous lysosomes and transitional cells with characteristics of both the fibroblast-like and histiocyte-like cells. Laryngeal microsurgery was performed as surgery and the patient has done well without recurrence to date (8 months after surgery).     

Malignant fibrous histiocytoma of the pharynx

Malignant fibrous histiocytoma (MFH) is the most common soft-tissue sarcoma of late adult life, but is relatively uncommon in the head and neck region. That region has been reported to be the origin of malignant fibrous histiocytoma in 3-10% of cases. Only one case of the tumor occurring in the pharynx has been reported. Histologically it is sometimes hard to distinguish this tumor from some sarcomas and pleomorphic carcinomas. The treatment of choice is a large surgical resection, while radiotherapy and chemotherapy are reserved for recurrences. The authors present a case of oropharyngeal malignant fibrous histiocytoma. The patient complained dysphagia and dyslalia progressively worsening in six months. Pharyngo-laryngoscopy revealed a mass of the left lateral wall of oro and hypopharynx. CT scan examination showed a capsuled mass which displaced but not involved the neck neurovascular structures; there was no evidence of linphonodal involvement. Transoral surgical excision of the mass was performed with the preservation of speech and swallowing. For more than 1 year postoperatively, there has been no evidence of the disease or metastasis.     

Malignant fibrous histiocytoma of the hypopharynx

Malignant fibrous histiocytoma has been the most common soft-tissue sarcoma of late adult life. However, it is relatively uncommon in the head and neck. Furthermore, there has been no report of malignant fibrous histiocytoma of the hypopharynx in the literature. The first case of malignant fibrous histiocytoma of the hypopharynx is presented. The patient, a 70-year-old male, underwent extended laryngectomy and elective neck dissection with primary tracheoesophageal shunt operation and pharyngeal myotomy for voice restoration following total laryngectomy. For more than 2 years, there has been no evidence of the disease or metastasis. He has the satisfactory phonatory and swallowing function.     

Malignant fibrous histiocytoma of the larynx

Malignant fibrous histiocytoma is a rare neoplasm composed of fibroblasts and histiocytes. It assumes several histologic forms, which account for its various names and the difficulty in its diagnosis and classification. A case thought to be the sixth malignant fibrous histiocytoma involving the larynx is presented. The treatment of choice is wide excision with close follow-up examination.     

Malignant fibrous histiocytoma of the mandible

Malignant fibrous histiocytoma (MFH) of the mandible is rare. We describe a case of MFH of the mandible with metastatic disease to the lungs. To our knowledge only 30 cases have been reported prior to the present case. In previously reported cases, there was a strong tendency for the posterior portion of the mandible to be affected by MFH; ours is only the second reported case involving the anterior portion of the mandible. We review the diagnosis, pathology, and treatment of this rare malignancy.     

上颌窦恶性纤维组织细胞瘤（病例报告及文献复习）

目的：探讨原发于上颌窦的恶性纤维组织细胞瘤（MFH）的病理，临床表现及治疗措施。方法：分析2例原发于上颌窦的恶性纤维组织细胞瘤的临床资料并复习相关文献。结果：（1）MFH在病理上主要表现为轮辐状排列的纤维母细胞的背景中多种细胞成分并存，瘤细胞异型性明显；（2）病情发展快，临床表现为面部肿痛，肿瘤体积大，术前无转移；（3）1例接受鼻侧切开术，术后4个月局部复发并发现肝脏转移；1例行上 骨次全切除术加放疗，术后1年发现颈部淋巴结转移，3年局部复发。结论：原发于上颌窦的MFH是一种罕见病，有特征性的病理表现，临床表现多样性，病情发展快，治疗上采取根治性手术切除并联合放疗及化疗的综合治疗措施。术后易于复发及转移，预后差。     

Malignant fibrous histiocytoma of the parotid gland

Primary malignant fibrous histiocytoma (MFH) arising in a major salivary gland is rare. We encountered a case of MFH affecting the parotid gland. The patient was a 54-year-old man diagnosed as having pleomorphic type of MFH after extended total parotidectomy. Examination of the resected specimen revealed the tumor had not been completely removed. Accordingly treatment consisted in the resection of MFH and radiotherapy in combination with chemotherapy using carboplatin (CBDCA). This postoperative therapy was effective in controlling the growth of the remaining tumor tissue. As the patient showed no signs of local recurrence and distant metastasis for 5 years, plastic surgery was performed to improve the serious deformation of the face with a free anterolateral thigh flap. Our literature review yielded 17 cases of parotid MFH and the 2-year survival rate was 33%.