A Rapid Growing and Huge Metastatic Malignant Fibrous Histiocytoma of the Abdominal Cavity: Report of a Case

Yasuyuki Miyakura, Hidenori Haruta, Toru Zuiki, Yoshinori Hosoya, Yoshikazu Yasuda, Hideo Nagai and Akira Tanaka*

Department of Surgery and Department of Pathology*, Jichi Medical University

Malignant fibrous histiocytoma (MFH), the most frequently occurring soft tissue sarcoma, originates in fibroblast cells, figures a high rate of metastasis or recurrence, and commonly metastasizes to the lung. We report a case of huge, rapidly growing metastatic intraabdominal MFH. A 45-year-old man with anorexia and epigastric discomfort admitted elsewhere was found in abdominal CT to have a huge solid tumor in the abdominal cavity, and was referred to Jichi Medical University Hospital for surgery. He had undergone radical resection of MFH of the left buttock 2 years earlier and a metastatic MFH of the right pleura 7 months earlier. Abdominal enhanced CT showed a low-density area (LDA) forming 'beak' image in the pancreas body. CT 5 months earlier had shown no such LDA. Gastroscopy showed a huge submucosal tumor with ulceration from the upper gastric body to the pyloric region, indicating a huge, rapidly growing tumor suspected of being pancreatic MFH metastasis, and necessitating by total gastrectomy and distal pancreatectomy with a negative surgical margin. Histopathological findings indicated a stromal tumor consisting of storiform spindle cells with invasion to both pancreas and stomach not decided the origin of recurrence, and similar to pathological findings in the MFH of the left buttock, and a definitive diagnosis of metastatic MFH.

Key words
malignant fibrous histiocytoma, metastasis, pancreas

Reprint requests
Yasuyuki Miyakura Department of Surgery, Jichi Medical University
3311-1 Yakushiji, Shimotsuke, 329-0498 JAPAN

Accepted
November 28, 2007

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