Malignant Fibrous Histiocytoma of the Kidney Treated with Nephrectomy and Adjuvant Radiotherapy: A Case Report

Both myxofibrosarcoma and undifferentiated pleomorphic sarcoma (UPS) are sarcomas that primarily occur in the extremities of older patients. UPS (previously known as malignant fibrous histiocytoma) is now considered a diagnosis of exclusion, representing a group of high-grade, heterogeneous tumors with no clear line differentiation and characterized by high rates of distant metastases. Myxofibrosarcoma (formerly myxoid variant of malignant fibrous histiocytoma) is a distinct histologic entity that is largely distinguished from UPS by its myxoid stroma and curvilinear vascular pattern. Myxofibrosarcoma tends to have a locally infiltrative behavior that can often be seen as T2 hyperintense “tails” on magnetic resonance imaging. Local recurrence rates can be as high as 61% and are independent of grade. Unlike other sarcomas, it is recommended that tumors be excised with at least a 2 cm margin around both clinically and radiographically evident tumor. Low-grade tumors do not tend to metastasize but can recur as high-grade tumors with increased metastatic potential. Surgery is the mainstay of treatment for localized disease. For high-grade tumors, this may require complex plastics and vascular reconstruction. Selecting cases for multimodality therapy, including radiation and chemotherapy, should be done on a case-by-case basis after review by a multidisciplinary sarcoma team with particular attention to a patient’s risk of local recurrence and distant metastases. Further studies into histology-specific therapeutic targets will help inform future clinical trials. This review contains 4 figures, 4 tables and 54 references Key words: chemotherapy, distant metastases, extremity sarcoma, local recurrence, malignant fibrous histiocytoma, myxofibrosarcoma, radiation, sarcoma, surgical margins, T2 hyperintense tails, undifferentiated pleomorphic sarcoma

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Malignant Fibrous Histiocytoma Metastatic to the Thyroid Gland

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1088 ◽

2012 ◽

Vol 3 (1) ◽

pp. 30-32

Author(s):

Akash Anand ◽

Christina J Yang ◽

Ronald G Amedee ◽

Win Naing ◽

Aynaud Foster Hebert

Keyword(s):

Case Report ◽

Thyroid Gland ◽

Literature Review ◽

Lower Extremity ◽

Head And Neck ◽

Malignant Fibrous Histiocytoma ◽

Adjuvant Radiotherapy ◽

Fibrous Histiocytoma ◽

Disease Treatment ◽

Case Basis

ABSTRACT Introduction Malignant fibrous histiocytoma (MFH) metastatic to the thyroid is rare. In this case report and literature review, we discuss the presentation, diagnosis and treatment of MFH. Materials and methods We present a case of MFH metastatic to the thyroid. A literature review on malignant fibrous histiocytoma involving the thyroid was performed. Results We present a case of MFH metastatic to the thyroid from a lower extremity primary, treated by excision. The initial diagnosis of MFH metastatic to the thyroid relies on history and histopathology. Treatment is excision, sometimes followed by adjuvant radiotherapy and/or chemotherapy. Conclusion This is the sixth documented case of MFH metastatic to the thyroid. Due to the rarity of this disease, treatment decisions should be made on a case-by-case basis. How to cite this article Yang CJ, Anand A, Amedee RG, Naing W, Hebert AF. Malignant Fibrous Histiocytoma Metastatic to the Thyroid Gland. Int J Head and Neck Surg 2012;3(1): 30-32.

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Myxofibrosarcoma and Undifferentiated Pleomorphic Sarcoma

10.2310/cgso.16110 ◽

2017 ◽

Author(s):

Ann Y Lee

Keyword(s):

Local Recurrence ◽

Malignant Fibrous Histiocytoma ◽

Fibrous Histiocytoma ◽

Distant Metastases ◽

Metastatic Potential ◽

Low Grade ◽

High Grade ◽

Recurrence Rates ◽

Undifferentiated Pleomorphic Sarcoma ◽

Pleomorphic Sarcoma

Both myxofibrosarcoma and undifferentiated pleomorphic sarcoma (UPS) are sarcomas that primarily occur in the extremities of older patients. UPS (previously known as malignant fibrous histiocytoma) is now considered a diagnosis of exclusion, representing a group of high-grade, heterogeneous tumors with no clear line differentiation and characterized by high rates of distant metastases. Myxofibrosarcoma (formerly myxoid variant of malignant fibrous histiocytoma) is a distinct histologic entity that is largely distinguished from UPS by its myxoid stroma and curvilinear vascular pattern. Myxofibrosarcoma tends to have a locally infiltrative behavior that can often be seen as T2 hyperintense “tails” on magnetic resonance imaging. Local recurrence rates can be as high as 61% and are independent of grade. Unlike other sarcomas, it is recommended that tumors be excised with at least a 2 cm margin around both clinically and radiographically evident tumor. Low-grade tumors do not tend to metastasize but can recur as high-grade tumors with increased metastatic potential. Surgery is the mainstay of treatment for localized disease. For high-grade tumors, this may require complex plastics and vascular reconstruction. Selecting cases for multimodality therapy, including radiation and chemotherapy, should be done on a case-by-case basis after review by a multidisciplinary sarcoma team with particular attention to a patient’s risk of local recurrence and distant metastases. Further studies into histology-specific therapeutic targets will help inform future clinical trials. This review contains 4 figures, 4 tables and 54 references Key words: chemotherapy, distant metastases, extremity sarcoma, local recurrence, malignant fibrous histiocytoma, myxofibrosarcoma, radiation, sarcoma, surgical margins, T2 hyperintense tails, undifferentiated pleomorphic sarcoma

Download Full-text