Radiation-induced intracranial malignant fibrous histiocytoma.

An autopsy case of radiation-induced intracranial malignant fibrous histiocytoma (fibroxanthosarcoma) is reported. The tumor developed in the region of the sella turcica 11 years after high dose radiotherapy of a chromophobe adenoma of the pituitary. The tumor had infiltrated the base of the brain as well as the base of the skull. Metastases were not found. The tumor was composed of an admixture of bizarre fibroblasts, histiocytes and giant cells, xanthoma cells and siderophages, with a storiform fibrous stroma. This appears to be the first documented instance of a malignant fibrous histiocytoma occurring intracranially after local x-irradiation.     

鼻咽癌放疗与颌骨恶性纤维组织细胞瘤

目的放射、创伤、骨坏死、化疗等可为骨组织恶性纤维组织细胞瘤（MFH）的诱因。探讨鼻咽癌（NPC）放疗后患者中出现的MFH。方法收集1998年4月至2005年10月确诊为上颌骨MFH患者的资料。所有患者确诊MFH前数年均曾诊断NPC，并行^60Co放疗。结果本组7例（NPC）分别在鼻咽癌行^60Co外照射放疗结束后4～9年确诊为上颌骨MFH，临床及病理表现与骨原发性MFH相同。结论NPC放疗时上颌骨亦接受了约50～80Gy的照射，放射为本组病例的可疑诱因。如采用直线加速器或钴^60Co外照射结合后装治疗NPC，可适当减少外照射剂量，从而减少颌骨接受的照射量，减少颌骨MFH等诱发癌、瘤的危险性。治疗放疗诱发的MFH应根据临床情况选择手术及化疗，建议慎用或不用放射治疗。     

Postirradiation malignant fibrous histiocytoma

Three patients who were treated successfully with postoperative external radiation therapy for ovarian carcinoma, endometrial adenocarcinoma and bilateral retinoblastoma respectively developed years later malignant fibrous histiocytoma (MFH) within the irradiated field. MFH is a recently described soft tissue sarcoma known for its dual fibroblastic and histiocytic differentiation resulting in a pleomorphic histologic appearance.     

Myxoid variant of malignant fibrous histiocytoma.

It has been generally recognized that malignant fibrous histiocytoma (MFH) may assume a highly myxoid, hypocellular appearance. Eighty cases of malignant fibrous histiocytoma having varying degrees of myxoid change were reviewed. These tumors typically arose on the extremities (leg, 61%; arm, 21%) of adults (peak age incidence, 60-69 years). They were usually attached to fascia (31%) or involved skeletal muscle (51%) and had a mucoid or translucent appearance. The myxoid areas consisted of widely spaced spindled and pleomorphic cells embedded in a matrix of acid mucopolysaccharides. The cellular areas were indistinguishable from those of the typical pleomorphic MFH. The rate of local recurrence of these tumors was 61%, and of metastasis, 23%, but metastasis was less likely when the tumor was small, superficially located, or had a prominent myxoid component. In fact, the degree of myxoid change was inversely related to the rate of metastasis. Therefore, because of the more favorable prognosis of the myxoid variant, it seems appropriate to separate it from the usual nonmyxoid form of MFH. The myxoid variant must also be clearly distinguished from benign myxoid lesions such as myxoma or nodular fasciitis, with which it is often confused.     

Primary malignant fibrous histiocytoma of bone.

A review of over 400 primary bone tumors yielded 11 lesions with features allowing classification as malignant fibrous histiocytoma on a purely histological basis. Correlation with roentgenograms and clinical data indicated that these tumors occurred as osteolytic lesions associated with a high incidence of pathologic fractures in the metaphyses of skeletally mature long bones. Nine patients developed pulmonary metastases and 3 developed lymph node metastases within 21 months following diagnosis. The average survival was 12 months in 6 of the 9 patients who had no secondary treatment in their metastases. Treatment of 3 patients with metastatic lesions with chemotherapy or radiotherapy has been clinically encouraging. Some evidence was obtained that either or both the histiocytic and fibroblastic component may metastasize. There is a need for biopsy of metastatic lesions and autopsy followup to more accurately assess the mode of spread and histologic type of the metastases.     

Chordoma and malignant fibrous histiocytoma. Evidence for transformation

Serial biopsy specimens of a histologically proven cervical chordoma in a 57-year-old woman taken at intervals over a 7-year period, demonstrate a progression and complete transformation to a malignant fibrous histiocytoma 5 years following radiation therapy. Intermediate spindle-shaped cells demonstrating keratin positivity were discovered, lending credence to the theory of cellular transformation. Additionally, a fine reticulin network was noted around the chordoma cells. A review of the literature is undertaken chronicling the documented associations of chordoma and sarcoma, followed by a discussion of the various causes proposed to explain this phenomenon.     

软组织恶性纤维组织细胞瘤术后辅助放化疗预后因素分析

、68.0%、53.0%和62个月.单因素分析显示肿瘤大小、分期及术后放疗等均和预后明显相关,而性别、年龄、肿瘤部位、术后化疗对总生存率无影响,多因素回归分析显示术后放疗为独立预后因素.单纯化疗、单纯放疗及化疗+放疗组疗效相似,但它们均优于无放化疗组.结论 体积较小、术后无转移的肿瘤预后较好,而术后治疗以术后辅助放疗者预后最好.     

CT FINDINGS OF MALIGNANT FIBROUS HISTIOCYTOMA

ＣＴＦＩＮＤＩＮＧＳＯＦＭＡＬＩＧＮＡＮＴＦＩＢＲＯＵＳＨＩＳＴＩＯＣＹＴＯＭＡＤａｉＪｉｎｇｒｕｉ戴景蕊，ＳｈｉＭｕｌａｎ石木兰，ＬｉＧｅｎｚｈｕ李根柱，ＬｕＮｉｎｇ吕宁（ＣａｎｃｅｒＩｎｓｔｉｔｕｔｅ（Ｈｏｓｐｉｔａｌ），ＣｈｉｎｅｓｅＡｃａｄｅ...     

Morphology of experimental malignant fibrous histiocytoma

The microscopic structure of tumors induced in rats by subcutaneous injections of 7,12-dimethylbenz(a) anthracene (DMBA) was studied. Most of them (90%) were histologically identical to malignant fibrous histiocytoma (MFH) in humans. This experimental model is useful in MFH morphogenesis and histogenesis studies in connection with the high frequency and synchronicity of tumor development and distinct localization of tumor at the site of injection.     

Primary malignant fibrous histiocytoma of larynx

Primary malignant fibrous histiocytoma is a rare tumour, more so in larynx. A case is described alongwith biological behaviour and therapy.     

Treatment of malignant fibrous histiocytoma of the heart.

Primary soft tissue sarcoma of the heart is encountered infrequently in clinical practice. Treatment is reported of an intracardiac malignant fibrous histiocytoma, consisting of maximal surgical resection followed by 5600 cGy of conventionally fractionated radiation therapy. Transesophageal echocardiograms done during follow-up were useful in assessing tumor control. Aspects of patient care are discussed in conjunction with a review of the available literature.     

39例恶性纤维组织细胞瘤临床分析

目的：探讨恶性纤维组织细胞瘤(MFH)的临床特点及合理治疗。方法：回顾性分析39例病例，其中6例为首程治疗病例，33例为院外局部手术后复发病例。按治疗方式分为两组：一组为单纯手术，共18例，另一组为手术加术后放疗，共2l例。结果：单纯手术组5年生存率为33％(6／18)，手术加术后放疗组为57％(12／21)。结论：MFH属于中高度恶性肿瘤，易出现局部复发和全身转移，术后放疗能降低局部复发率。     

Myxoid malignant fibrous histiocytoma of the bladder

Although the most common soft tissue sarcoma of adulthood, malignant fibrous histiocytoma (MFH) is an extremely rare tumor of the urinary bladder. Only three well-documented cases have been reported in the world literature. The patient presented in this report represents the first case of the myxoid variant to develop in the urinary bladder. Whereas all previous patients with MFH of the bladder had intermittent hematuria, this patient's chief complaint was bladder outlet obstruction due to extension of the tumor into the prostate. He was managed with radical cystoprostatectomy, postoperative radiation therapy to the tumor bed, and adjuvant chemotherapy using doxorubicin. The patient tolerated the therapy well and was disease-free at the 3-year follow-up visit. The histogenesis, clinical features, pathologic characteristics, and treatment considerations of this rare bladder tumor are discussed in detail.     

A malignant fibrous histiocytoma of the breast

We have experienced treating a 49-year-old female with a malignant fibrous histiocytoma (MFH) arising from the right mammary gland. Nine months after surgery, lung metastasis occurred but the lung lesion proved to be resectable. Our findings suggested that the primary lesion had originated from a phyllodes tumor. MFH arising from the mammary gland is an extremely rare tumor, and only 12 such cases have been reported including that of our patient.     

Primary intrathoracic malignant fibrous histiocytoma and angiosarcoma

Primary intrathoracic malignant fibrous histiocytoma and angiosarcoma are rare sarcomas constituting less than 0.2% of lung cancers. The typical imaging appearance is a large, well-circumscribed, non-cavitating, non-calcified, peripheral lung mass without hilar or mediastinal lymphadenopathy. Bronchoscopy and percutaneous needle aspiration are of limited value in differential diagnosis, and thoracotomy is warranted for definitive diagnosis.     

Primary malignant fibrous histiocytoma of the thyroid

Aims and methods

To study the clinical features, diagnosis, and treatment of primary malignant fibrous histiocytoma of the thyroid (MFH-T). Treatment and outcome were analyzed retrospectively in a consecutive series of 12 patients with primary MFH-T treated at the Cancer Hospital of the Chinese Academy of Medical Sciences from 1987 to 2007.

Results

All 12 patients underwent surgery; surgery alone was used in four patients. Five patients were given post-operative radiotherapy, and one patient was given pre-operative radiotherapy. Two patients were given post-operative chemotherapy. Five patients had locoregional recurrence, and five had distant metastases in follow-up. Median survival was 9 months. One patient is alive, and has no evidence of disease. Six patients died six months after treatment, and the other four patients died in 10, 14, 18, and 24 months after treatment, respectively. Nine patients died of the disease, and one patient died of cerebral hemorrhage after treatment.

Conclusion

Primary MFH-T is very rare and has a poor prognosis. Although surgical resection of MFH-T is the treatment of choice in MFH-T, the results are unsatisfactory.     

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.     

Chemotherapy of malignant fibrous histiocytoma of bone

BACKGROUND:: Malignant fibrous histiocytoma of bone (MFHB) is a rare tumourwith a 3 year survival of 30%-40% when treated with surgeryalone. A small number of patients have previously been treatedwith pre-operative chemotherapy and responses observed. Theaim of the present study was to further determine the responseof MFHB to pre-operative chemotherapy. PATIENTS AND METHODS:: A non-randomised study of 18 patients with MFHB. Twelve hadlocalised disease and 6 had pulmonary metastases. In 14 patientspre-operative treatment consisted of methotrexate 8 g/m² onday 1, ifosfamide 3 g/m² and doxorubicin 60 mg/m² on day 10.This regimen was given twice and twice post-operatively. A further4 patients received cisplatin 100 mg/m² on day ] and doxorubicin25 mg/m² on days 1, 2, 3. Three cycles were given preand post-operatively. RESULTS:: 15 patients had surgery after chemotherapy. Tumour necrosiswas present in all resection specimens and ranged from 50%–100%.7/15 had >90% necrosis. Disease free survival is 82% forthose patients with a greater than 2 year follow-up. CONCLUSION:: This study confirms previous reports that MFHB is a chemosensitivetumour. In view of its rarity collaborative trials are neededto establish the optimum drug treatment including drug selectiondose and duration. bone sarcoma, chemotherapy