Rare presentation of carcinosarcoma arising in bladder diverticulum

An 87-year-old man presented with hematuria and dysuria. An endoscopic examination revealed a bladder mucosa which was almost entirely occupied by diverticula. On the left lateral wall of the bladder there was a huge diverticulum which contained a 12 cm mass extending beyond the bladder wall in the extraperitoneal tissues. Upon histological examination the mass proved to be a carcinosarcoma which was composed by a squamous carcinoma and a sarcoma resembling a malignant fibrous histiocytoma. The two components, i.e. carcinomatous and sarcomatous, were separated by a sharp collision border and no intermingling was ever noted. The epithelial component showed immunoreactivity for cytokeratin and EMA, while the mesenchymal component was diffusely reactive for vimentin, alpha-1-antitrypsin and lysozime. Both components were reactive for galectin-3, whereas S100, desmin and smooth muscle actin were negative. This is the fourth reported case of carcinosarcoma originating in a bladder diverticulum.     

Myxoid malignant fibrous histiocytoma of the ovary: a case report

A 46-year-old woman presented with whole abdominal discomfort, and imaging revealed a 3-cm-sized ill-defined ovarian mass with extensive peritoneal carcinomatosis. Histologic examination showed malignant fibrous histiocytoma of ovary with predominant myxoid stroma. Microscopic examination showed a highly cellular neoplasm composed of fibroblast-like cells with a predominant myxoid stroma and high pleomorphism and mitotic activity. Immunohistochemically, the tumor was negative for smooth muscle actin, desmin, S-100, pancytokeratin, c-kit, epithelial membrane antigen, and calretinin. Malignant fibrous histiocytoma of ovary is extremely rare, with only six previously reported cases. To the best of our knowledge, the myxoid type of malignant fibrous histiocytoma of ovary has not been previously reported in the English literature except for a case arising in a dermoid cyst of ovary. We present the case and briefly discuss the differential diagnosis.     

Malignant Fibrous Histiocytoma Presenting as an Intraventricular Mass Five Years after Incidental Detection of a Mass Lesion

Malignant fibrous histiocytoma is a rare intracranial neoplasm. It usually presents as a meningeal mass but occurs also intraaxially. Few information is available on cellular origin, premalignant histologic stages and time course of malignant transformation. We report a case of a primary intraventricular malignant fibrous histiocytoma in a patient who five years prior to clinical manifestation of the malignancy was found to have an intraventricular mass with benign CT characteristics.     

Primary malignant fibrous histiocytoma of the jejunum metastatic to the spine

We report a case of malignant fibrous histiocytoma (MFH) metastatic to the spine. A 41-yr-old male was admitted to our hospital for radiation treatment of MFH of the spine. He began to show signs suggestive of partial small bowel obstruction. Computed tomography demonstated jejuno-jejunal intussusception. The patient was taken to the operating room, where the diagnosis was confirmed. Partial jejunal resection was performed. The lead point of the intussusception was histologically diagnosed to be a high-grade malignant fibrous histiocytoma. We believe that the spinal lesion was the metastatic lesion and that metastasis occurred via the vessels of Adamciewicz. To our knowledge this is the first case thus reported.     

A case of interleukin-6-producing malignant fibrous histiocytoma originating in the heart.

Primary cardiac malignant fibrous histiocytoma is extremely rare and its pathophysiological characteristics remain largely unknown. We treated a female patient with persistent fever and disseminated intravascular coagulation. Since ultrasonic echocardiography revealed the presence of a cardiac tumor and her serum interleukin-6 level was elevated, we speculated she had a cardiac myxoma. Histological examination of the surgically resected specimen, however, revealed that the tumor was malignant fibrous histiocytoma. Although her disseminated intravascular coagulation and heart failure were transiently improved after operation, local recurrence and systemic metastasis occurred and she died 7 weeks after operation. Using the autopsied specimen, we examined whether the malignant fibrous histiocytoma constitutively synthesized interleukin-6. The interleukin-6 content in the tumor was high, consistent with interleukin-6 production by the tumor. This was confirmed by immunohistochemical analysis. To our knowledge, this is the first report demonstrating interleukin-6 production by a cardiac malignant fibrous histiocytoma.     

Malignant fibrous histiocytoma (MFH) arising within a cholecystectomy incision: a cause-and-effect relationship is possible between previous surgery and the development of a malignant fibrous histiocytoma within the operative site

We present a report of a patient who, after an uneventful cholecystectomy, developed an incisional mass that proved to be a malignant fibrous histiocytoma and had to be excised. Five months later, the patient developed a similar incisional mass, which was shown to be a malignant fibrous histiocytoma and again had to be excised. The rarity of such a case and the details of the patient's case history are reported. The implications of a possible relationship between previous surgery, the patient's healing response, and the development of these tumors are discussed.     

脑部恶性纤维组织细胞瘤1例报道

Malignant fibrous histiocytoma (MFH) firstly described as "malignant fibrous xanthoma" by O'Brien and Stout in 1964, is the most common soft tissue sarcoma of late adult life. Uncertain histogenesis and numerous subtypes make MFH a rather controversial entity. MFH only rare arises from structures of the head and neck. When it does, it most often originates in facial structures, particularly the maxilla. This report details a case of a patient with malignant fibrous histiocytoma presenting clinically as a right-sided large indurated frontoparietal mass, three months after head trauma and eight years after radiation therapy for brain lymphoma located in the right frontal and parietal lobes. Radical excision was a surgical challenge because of the extensiveness of the lesion.     

Lymphocytosis in a patient with malignant fibrous histiocytoma

Malignant fibrous histiocytoma is an uncommon soft-tissue sarcoma. Patients with malignant fibrous histiocytoma may present with unusual clinical findings and an apparent association with malignant hematopoietic disease has been reported. We describe a patient in whom a diagnosis of chronic lymphocytic leukemia was made simultaneously with discovery of a large, retroperitoneal malignant fibrous histiocytoma. Following surgical debulking of the tumor, the patient's blood and bone marrow findings returned to normal.     

Malignant (fibrous) histiocytoma of bone--fact or fancy?.

Malignant (fibrous) histiocytoma is currently defined as a malignant primary bone tumor that contains a mixture of fibrogenic cells and cells that are histologically similar but which appear to be histiocytic. In this type of histiocytoma the nuclei are often indented; cytoplasm is usually abundant and may be slightly foamy; nucleoli are often large; and multinucleated malignant cells are usually a prominent feature. Many dedifferentiated chondrosarcomas, osteosarcomas, and fibrosarcomas of bone contain areas that resemble what we regard as malignant (fibrous) histiocytoma. When the entirety of a malignant tumor of bone fits the outlined histologic pattern, the designation of malignant (fibrous) histiocytoma seems appropriate. From 158 fibrosarcomas of bone and 962 osteosarcomas of bone in our files, 35 tumors were segregated because they appeared to be properly designated as malignant (fibrous) histiocytoma. A wide age range was represented by affected patients, and a large variety of bones harbored these tumors. Approximately one-third of patients eligible for 5-year follow-up were long-term, symptom-free survivors. Four deaths occurred from the tumor after more than 5 years, and one patient had radiographic evidence of pulmonary metastasis 7 years after amputation. Radiation therapy has been curative in at least two cases. The correct designation for these tumors in the light of current knowledge is malignant tumor, consistent with malignant (fibrous) histiocytoma.     

Malignant fibrous histiocytoma of the scrotum

A 72-year-old man was hospitalized for a gradually enlarging left scrotal mass. Physical examination revealed a 3 X 4 cm. rock hard non-tender mass fixed to adacent tissue. The tumor invaded the skin of scrotum and showed ulcer formation. Surgical therapy was performed under the diagnosis of left scrotic tumor. The resected mass was examined histologically, and the pathologic diagnosis was of malignant fibrous histiocytoma of the left scrotum was made.     

Malignant fibrous histiocytoma in bone infarct. Association with sickle cell trait and alcohol abuse

A 42-year-old black man with sickle cell trait and a history of alcohol abuse had a malignant fibrous histiocytoma of the distal femur. The tumor developed in a bone infarct that had been present for at least 54 months. This is the first reported association of malignant fibrous histiocytoma and bone infarct in which the infarct was related to sickle cell trait and alcohol abuse. A detailed map of the sections from the resected femur disclosed a spectrum of cytologic changes in the sarcoma that ranged from bland fibroblasts in the center of the tumor to high-grade sarcoma at the periphery. Awareness of this spectrum has diagnostic importance regarding the potential underdiagnosis of well-differentiated malignant fibrous histiocytoma.     

Primary malignant fibrous histiocytoma of the esophagus

A 59-year-old man was admitted to the hospital for dysphagia and fever. Esophagogram and upper gastrointestinal endoscopy revealed a polypoid mass in the midesophagus. Subtotal esophagectomy, cervical esophagogastrostomy, and lymph node dissection were performed. The histological diagnosis of the tumor was malignant fibrous histiocytoma. An area of severe epithelial dysplasia was found in the esophageal mucosa 3 cm under the tumor.     

腹膜后巨大恶性纤维组织细胞瘤误诊1例并文献复习

目的观察腹膜后恶性纤维组织细胞瘤的临床表现、病理形态及免疫组化特点，吸取误诊教训。方法通过对1例腹膜后恶性纤维组织细胞瘤的临床表现、光镜形态及多次免疫组化结果进行观察，明确诊断，并复习相关文献。结果恶性纤维组织细胞瘤多发于中老年男性。根据镜下所见及第一次免疫组化结果曾诊断为巨大恶性神经鞘膜瘤。后又经多次免疫组化结果S-100（-），NF（-），排除恶性神经鞘膜瘤的可能；经多次专家会诊及远程会诊，确诊为腹膜后巨大恶性纤维组织细胞瘤。结论原发性腹膜后恶性肿瘤比较多样化，因此他的确诊依赖于镜下形态和可靠的免疫组化结果，这些经验教训值得大家借鉴。     

A Report of Primary Brain Fibrosarcoma with Literature Review

Primary fibrosarcoma of the central nervous system (CNS) is an extremely rare tumor. To the best of our knowledge, only 40 cases have been reported in the literature. We document such a case in a 9-year-old child who presented with a short history of headache and vomiting. A mass was completely removed and histologic examination revealed a primary fibrosarcoma with features resembling solitary fibrous tumor, meningioma, and malignant fibrous histiocytoma. In addition, the tumor was associated with meningioangiomatosis. A primary CNS fibrosarcoma with these features is most unusual and rendered a precise diagnosis difficult.     

Aneurysmal ("angiomatoid") fibrous histiocytoma of the skin

Seventeen cases are reported of a variety of cutaneous fibrous histiocytoma, which we have designated as aneurysmal ("angiomatoid") fibrous histiocytoma. These lesions differ from the classical cutaneous fibrous histiocytoma in both their clinical presentation and pathologic features. Clinically, they may be larger than the usual cutaneous fibrous histiocytoma, are blue, black, or dark red, and have a cystic consistency. They are most commonly located on the extremities and may be associated with symptoms of pain and rapid growth. The clinical diagnosis of fibrous histiocytoma is seldom considered in the differential diagnosis, which may include malignant melanoma, hemangioma, neurofibroma, and nonspecific cyst. Histologically, the lesions are characterized by the presence of large, blood-filled tissue spaces, which, at times, account for up to one half their size. These spaces lack an endothelial lining, being surrounded and lined by histiocytes, many of which contain hemosiderin pigment, fibroblasts, and foam cells. The solid portions of the tumor have the usual features of a cutaneous fibrous histiocytoma. This "angiomatoid" lesion is closely allied to what has been termed "hemosiderin histiocytoma," which appears to be a precursor stage in its formation. The presence of extravasated erythrocytes in combination with a spindle-cell stroma may lead to an erroneous diagnosis of Kaposi's sarcoma. This cutaneous tumor has architectural and cytologic similarities to its malignant soft tissue counterpart recently described as angiomatoid malignant fibrous histiocytoma. However, unlike the latter, the cutaneous lesion is benign and lacks the prominent inflammatory infiltrate, pleomorphic appearance, and systemic manifestations of its soft tissue counterpart. The distinctive clinical and pathologic features of the cutaneous lesion serve to separate it as a specific variant of the cutaneous fibrous histiocytomas.     

Postirradiation malignant fibrous histiocytoma in a patient with squamous carcinoma of the uterine cervix--an autopsy case

An autopsy case of postirradiation sarcoma is described. The tumor, a malignant fibrous histiocytoma, occurred in the radiation fied 7 years after postoperative external beam radiation therapy (6000 rad) for squamous cell carcinoma of the cervix. To our knowledge, 11 cases of postirradiation malignant fibrous histiocytoma have been reported in the literature and only one occurrence of this neoplasm after treatment for cervical cancer has been described. We review the literature on postirradiation sarcoma with special attention to malignant fibrous histiocytoma.     

Benign and malignant fibrous histiocytomas of the soft tissues: functional characterization of the cultured cells

Cell cultures were carried out from fresh tumor tissues obtained from seven cases of histiocytic tumors of the soft tissues including four of malignant fibrous histiocytoma, two of benign fibrous histiocytoma, and one of giant cell tumor of tendon sheath. The cultured cells were studied by light and electron microscopy, rosette formation for surface receptors, immune phagocytosis, and enzyme cytochemistry. The culture of each tumor revealed a mixture of histiocyte-like cells, fibroblast-like cells, amd intermediate forms. Bizarre giant cells were numerous in the early cultures of malignant fibrous histiocytoma, but they were absent in the cultures of benign fibrous histiocytoma and giant cell tumor of tendon sheath. In all the seven cases the cultured cells exhibited several features characteristic of histiocytes: (1) surface receptors for the Fc-portion of immunoglobulin G; (2) surface receptors for the third component of complement; (3) immune phagocytosis of opsonized erythrocytes; and (4) lysosomal enzymes including alpha-naphthyl butyrate esterase, and acid phosphatase. These findings suggest that the histiocytic tumors of the soft tissues in discussion actually comprise the cells that have the functional property of histiocyte. The tumor cells in the surgical specimens presented essentially the same ultrastructural and enzyme histochemical characteristics as those of the cultured cells.     

恶性纤维组织细胞瘤一例报道

临床资料 患者,男,86岁,主因“发现左大腿肿胀1年,加重1个月”入院。患者30年前有腰椎结核病史,服用抗结核药物治疗2年后腰疼,肿胀症状消失。患者近1年无进行性消瘦,乏力及盗汗。入院查体：左大腿中上段肿胀,皮下静脉显现,局部皮温较对侧高,张力大,无压痛。左下肢活动无明显异常,左胫前轻度凹陷性水肿。     

Primary Renal Malignant Fibrous Histiocytoma Four-Case Report and Review of the Literature

OBJECTIVE To evaluate the diagnosis and treatment for primary renal malignant fibrous histiocytoma, a rare tumor arising from the kidney.METHODS The clinical and pathological data from 4 cases of malignant fibrous histiocytoma of the kidney detected in our hospital are described.One case of special interest involved a giant cell subtype, the first to be reported in the oncology literature. The clinicopathologic features and prognostic factors of this tumor were analysed and summarized after reviewing 55 documented cases in the English and Chinese literature.RESULTS A palpable mass (71.2%), emaciation (54.2%) and pain (54,2%) were common manifestations in renal MFH, Of all the cases, 51 were identified as a storiform-pleomorphic subtype by pathologists. Inconsideration of all the prognosis related factors, the residual tumor and high TNM stage predicted a shortened survival duration, but the symptom of a fever served as a better prognostic factor.CONCLUSION Malignant fibrous histiocytoma which arises from the kidney is a rare pathologic type, and possesses a high tendency towards local recurrence and distant metastasis. Despite the poor prognosis, early detection and radical surgery can prolong survival in selected cases.     

Postirradiation sarcoma (malignant fibrous histiocytoma) following cervix cancer

A case of postirradiation sarcoma is described. The tumor, a malignant fibrous histiocytoma, occurred in the radiation field 11 years following postoperative external beam radiation therapy (7000 rad) for carcinoma of the cervix. Reports of postirradiation malignant fibrous histiocytoma are rare, and the occurrence of this neoplasm following treatment of cervix cancer has not previously been described. The literature concerning postirradiation bone and soft tissue sarcomas is briefly reviewed, with special attention to malignant fibrous histiocytomas.