Malignant fibrous histiocytoma originating from the mesorectum: a case report
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Malignant fibrous histiocytoma originating from the mesorectum: a case report Yoshifumi Nakayama*, Noritaka Minagawa, Takayuki Torigoe, Koji Yamaguchi
Abstract Background: Malignant fibrous histiocytoma (MFH) is a common sarcoma affecting soft tissues of the body, especially of the extremities or trunk. Prognosis of the abdominal MFH is usually poor. Case presentation: A 52-year-old female presented to our surgical outpatient clinic with a lower abdominal tumor that had been gradually increasing in size. Clinical examination revealed a firm, irregularly surfaced, fixed, painless, child-head-sized tumor located in her lower abdomen. Computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen revealed a polycystic tumor at the lower abdomen which was 15 × 13 × 11 cm in diameter and encased the colorectum to the left back side. A barium enema and a colonoscopy showed direct invasion to the rectum. In 2001, the tumor had been excised along with a low anterior resection of the rectum because of direct invasion. The origin of this tumor was the mesorectum. The weight of the excised tumor was 1,500 g, including 800 ml of a brown fluid. A histopathological diagnosis revealed a common type of MFH, in which mitotic figures are frequently seen. Conclusion: This patient has survived without recurrence, for approximately 8 years since the completed tumor resection. It is important to obtain a complete resection during the MFH treatment.
Background Malignant fibrous histiocytoma (MFH) is a common sarcoma affecting soft tissues of the body, especially of the extremities or trunk [1-3]. The tumor cells are derived from histiocytes capable of fibroblastic transformation [4]. MFH is an aggressive tumor with a high potential of demonstrating metastasis to other parts of the body. The prognosis of patients with abdominal MFH is usually poor [5]. Primary mesenteric MFH is a rare disease and few cases have been reported in the English literature [6-10]. We herein report a surgical case of MFH that originated from the mesorectum and affected the rectum. Case Report A 52-year-old female presented to our surgical outpatient clinic with a lower abdominal tumor that had been gradually increasing in size. She first noticed a fist sized, painless tumor about four months ago. Clinical examination revealed a firm, irregularly surfaced, fixed, * Correspondence: [email protected] Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Japan
painless, child-head-sized tumor in her lower abdomen. Laboratory data showed that she had a white blood cell count of 5500/mm3, hemoglobin of 8.3 g/dl, hematocrit of 25.4%, platelets count of 429,000/mm3, normal electrolytes, as well as normal blood urea nitrogen levels and the liver function. Computed tomography (CT) of the abdomen demonstrated a large tumor in the lower abdomen which was 15 × 13 × 11 cm in diameter and encased the colorectum to the left back side (Figure 1A). Ma
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