Malignant Fibrous Histiocytoma Arising in the Liver Complicated with Intrahepatic Cholestasis

Chikara Kunisaki, Syunsuke Kobayashi, Yasuhiro Kido, Toshimichi Takahashi, Takeshi Yamanouchi, Eisyuu Kanemura, Chitaka Kasaoka

Department of Surgery, Fujisawa City Hospital

A 73-year-old woman was admitted to our hospital with the chief complaint of epigastralgia. Ultrasonography, computed tomography and endoscopic retrograde cholangiopancreatography reveald hepatolithiasis in the left lobe, choledocholithiasis and cholelithiasis. At surgery, a solid tumor arising in the left lobe of the liver and invading the left diaphragma and posterior wall of the stomach was detected in addition to the stones. Resection of the left lateral segment, fundic gastrectomy with partial resection of the left diaphragma, cholecystectomy and choledochotomy with T-tube drainage were performed under the diagnosis of cholangiocarcinoma. The tumor was pathologically diagnosed as malignant fibrous histiocytoma originating from the liver on the basis of the findings of the storiform pleomorphic pattern, atypical giant cells and cells positive for α₁-antitrypsin. She died 5.5 months after the operation because of recurrence in the residua liver. Malignant fibrous histiocytoma in the soft tissue is a common disease, but it rarely originates from the gastrointestinal tract and, very rarely arises in the liver. Our case is the 18th case in the literature.

Key words
malignant fibrous histiocytoma, intrahepatic cholestasis

Reprint requests
Chikara Kunisaki Department of Surgery, Fujisawa City Hospital
2-6-l Fujisawa, Fujisawa City, 251 JAPAN

Accepted
March 2, 1994

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