Clinical characteristics of the primary hepatic malignant fibrous histiocytoma in China: case report and review of the literature

World Journal of Surgical Oncology

Chaoliu Dai¹  Dianbo Yao¹ 

[1] Department of Hepatobiliary and Splenic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China

关键词: Therapy;    Diagnosis;    Liver neoplasms;    Malignant fibrous histiocytoma;   

Others  :  828120
DOI  :  10.1186/1477-7819-10-2

 received in 2011-07-31, accepted in 2012-01-05,  发布年份 2012

【 摘 要 】

Background

A malignant fibrous histiocytoma is a soft tissue tumor that most commonly occurs in the extremities, but rarely involves the liver. The clinical characteristics and therapeutic experiences of primary hepatic malignant fibrous histiocytoma are still limited.

Methods

Two cases of primary hepatic malignant fibrous histiocytoma were analyzed retrospectively, and all the literature concerning primary hepatic malignant fibrous histiocytoma was analyzed.

Results

In China, a total of 76 cases had been reported, among which 50 were men, with a male to female ratio of 1.9:1. Mean age of the patients was 51.0 years old, and more than 85 percent were older than 40 years. 82.9 percent (63/76) of hepatic MFH were solitary lesions, with tumor size ranging from 2.5 to 23.5 cm (average 10.3 cm). Major clinical presentation (78.4%) was abdominal pain or discomfort, accompanied with some other non-specific symptoms such as malaise, anorexia, weight loss, jaundice and fever, and small cases (14.9%) were asymptomatic. Computed tomography and ultrasound usually revealed the location of lesions. The rate of pre-operative misdiagnosis was extremely high, and 14.9 percent of patients were even misdiagnosed as a benign liver cyst, liver abscess or hematoma. Integrated resection was performed among the most cases (49/68), among which only a few ones (12 cases) were introduced to have no recurrence or metastasis or be still alive with no detail information provided, while among the cases with palliative operation or only a biopsy, the cases that were followed-up all died.

Conclusions

Hepatic malignant fibrous histiocytoma is a rare malignant mesenchymal tumor. The variable features of clinical presentations and images make the diagnosis difficult. Though the prognosis of primary hepatic malignant fibrous histiocytoma was rather poor, integrated resection might provide a few cases a good opportunity for surviving, suggesting that surgery might be an effective treatment.

【 授权许可】

   
2012 Yao and Dai; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]O'Brien JE, Stout AP: Malignant fibrous xanthomas. Cancer 1964, 17:1445-55.
• [2]Weiss SW, Enzinger FM: Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer 1978, 41:2250-66.
• [3]Kransdorf MJ: Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol 1995, 164:129-34.
• [4]Matushansky I, Charytonowicz E, Mills J, Siddiqi S, Hricik T, Cordon-Cardo C: MFH classification: differentiating undifferentiated pleomorphic sarcoma in the 21st Century. Expert Rev Anticancer Ther 2009, 9:1135-44.
• [5]Alberti-Flor JJ, O'Hara MF, Weaver F, Evans J, McClure R, Dunn GD: Malignant fibrous histiocytoma of the liver. Gastroenterology 1985, 89:890-3.
• [6]Conran RM, Stocker JT: Malignant fibrous histiocytoma of the liver--a case report. Am J Gastroenterol 1985, 80:813-5.
• [7]Fukayama M, Koike M: Malignant fibrous histiocytoma arising in the liver. Arch Pathol Lab Med 1986, 110:203-6.
• [8]Arends JW, Willebrand D, Blaauw AM, Bosman FT: Primary malignant fibrous histiocytoma of the liver--a case report with immunocytochemical observations. Histopathology 1987, 11:427-31.
• [9]Bruneton JN, Drouillard J, Rogopoulos A, Laurent F, Normand F, Balu-Maestro C, Monticelli J: Extraretroperitoneal abdominal malignant fibrous histiocytoma. Gastrointest Radiol 1988, 13:299-305.
• [10]Honda H, Nakamura Y, Kajiwara T, Muranaka T, Yoshida K, Tomooka K, Oshiumi Y, Teshima K: Malignant fibrous histiocytoma of the liver. Comput Med Imaging Graph 1988, 12:131-4.
• [11]Katsuda S, Kawahara E, Matsui Y, Ohyama S, Nakanishi I: Malignant fibrous histiocytoma of the liver: a case report and review of the literature. Am J Gastroenterol 1988, 83:1278-82.
• [12]Hamasaki K, Mimura H, Sato S, Sakai H, Miyashima T, Gochi A, Orita K: Malignant fibrous histiocytoma of the liver--a case report. Gastroenterol Jpn 1991, 26:666-73.
• [13]Akifuji Y, Honjo I, Katayama S, Ishitobi S, Ueki J, Kishi K, Kato K, Nakamoto S: Malignant fibrous histiocytoma of the liver: a case report and review of the literature. Intern Med 1992, 31:284-8.
• [14]Zornig C, Kremer B, Henne-Bruns D, Weh HJ, Schröder S, Brölsch CE: Primary sarcoma of the liver in the adult. Report of five surgically treated patients. Hepatogastroenterology 1992, 39:319-21.
• [15]McGrady BJ, Mirakhur MM: Recurrent malignant fibrous histiocytoma of the liver. Histopathology 1992, 21:290-2.
• [16]Reed JG, Goodman P, Soloway RD: Primary malignant fibrous histiocytoma of the liver MRI findings. Magn Reson Imaging 1993, 11:139-43.
• [17]Pinson CW, Lopez RR, Ivancev K, Ireland K, Sawyers JL: Resection of primary hepatic malignant fibrous histiocytoma, fibrosarcoma, and leiomyosarcoma. South Med J 1994, 87:384-91.
• [18]Fujita S, Lauwers GY: Primary hepatic malignant fibrous histiocytoma: report of a case and review of the literature. Pathol Int 1998, 48:225-9.
• [19]Wunderbaldinger P, Schima W, Harisinghani M, Saini S: Primary malignant fibrous histiocytoma of the liver: CT and MR findings. AJR Am J Roentgenol 1998, 171:900-1.
• [20]Ferrozzi F, Bova D: Hepatic malignant fibrous histiocytoma: CT findings. Clin Radiol 1998, 53:699-701.
• [21]Yu JS, Kim KW, Kim CS, Yoon KH, Jeong HJ, Lee DG: Primary malignant fibrous histiocytoma of the liver: imaging features of five surgically confirmed cases. Abdom Imaging 1999, 24:386-91.
• [22]Maekawa T, Yabuki K, Sato K, Tamasaki Y, Maekawa H, Ogawa K, Hirano A, Eguchi M, Matsumoto M: A case of fibrous histiocytoma of the liver. Nihon Geka Hokan 1999, 68:14-23.
• [23]Anagnostopoulos G, Sakorafas GH, Grigoriadis K, Kostopoulos P: Malignant fibrous histiocytoma of the liver: a case report and review of the literature. Mt Sinai J Med 2005, 72:50-2.
• [24]Ding GH, Wu MC, Yang JH, Cheng SQ, Li N, Liu K, Dai BH, Cong WM: Primary hepatic malignant fibrous histiocytoma mimicking cystadenocarcinoma: a case report. Hepatobiliary Pancreat Dis Int 2006, 5:620-3.
• [25]Ye MF, Zheng S, Xu JH, Chen LR: Primary hepatic malignant fibrous histiocytoma: a case report and review of the literature. Histol Histopathol 2007, 22:1337-42.
• [26]Chen HC, Chen CJ, Jeng CM, Yang CM: Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture. World J Gastroenterol 2007, 13:6441-3.
• [27]Li YR, Akbari E, Tretiakova MS, Hart J, Akbari M, Urbanski SJ, Gao ZH: Primary hepatic malignant fibrous histiocytoma: clinicopathologic characteristics and prognostic value of ezrin expression. Am J Surg Pathol 2008, 32:1144-58.
• [28]Sugitani M, Aramaki O, Kikuchi K, Sheikh A, Oinuma T, Mamiya T, Takayama T, Nemoto N: Two cases of primary malignant fibrous histiocytoma of the liver: immunohistochemical expression of ezrin and its relationship with prognosis. Acta Histochem Cytochem 2009, 42:83-8.
• [29]Kim HS, Kim GY, Lim SJ, Lee SM, Kim YW: Undifferentiated pleomorphic sarcoma of the liver presenting as a unilocular cyst. Hepatobiliary Pancreat Dis Int 2009, 8:541-3.
• [30]Caldeira A, Martin-Carreras F, Pereira E, Sousa R, Gonçalves R, Tristan J, Banhudo A: Malignant fibrous histiocytoma--a rare hepatic tumor. Rev Esp Enferm Dig 2010, 102:146-7.
• [31]Cong Z, Gong J: Primary malignant fibrous histiocytoma of the liver: CT findings in five histopathological proven patients. Abdom Imaging 2011, 36:552-556.
• [32]Fletcher CD: The evolving classification of soft tissue tumours: an update based on the new WHO classification. Histopathology 2006, 48:3-12.
• [33]Ishak KG, Goodman ZD, Stocker JT: Malignant mesenchymal tumors. In Tumors of the Liver and Intrahepatic Bile Ducts. Fascicle 31, Atlas of Tumor Pathology, Third Series. Edited by Rosai J, Sobin LH. Armed Forces Institute of Pathology, Washington DC; 2001:280-330.