Malignant fibrous histiocytoma originating from the chest wall: report of a case and collective review of cases

Long-Term Survival after Wide Resection of Malignant Fibrous Histiocytoma of the Chest Wall

Primary malignant fibrous histiocytoma (MFH) of the chest wall is extremely rare and is characterized by aggressive features, including a high incidence of local recurrence and distant metastasis. Surgical resection of the chest wall is the primary modality of management. However, surgical treatment is not generally recommended in patients with evidence of distant metastasis. Here, we present a case of chest wall MFH along with a schwannoma mimicking distant metastasis in the right upper arm. The patient was treated by radical en bloc resection and survived for more than 9 years without recurrence.

Primary malignant fibrous histiocytoma of the chest wall misdiagnosed as traumatic hemothorax

Malignant fibrous histiocytoma (MFH), a type of sarcoma, is a malignant neoplasm with uncertain origins that arise from both the soft tissues and the bone. The occurrence of MFH on the chest wall is extremely rare. We hereby report a case of a 72-year-old woman who was incidentally detected with MFH after a traffic accident.

CyberKnife radiotherapy for malignant fibrous histiocytoma of the chest wall: A case report and review of the literature

Malignant fibrous histiocytoma (MFH) is the most common type of soft tissue sarcoma, but rarely originates in the chest wall. Surgical resection is considered to be the most reliable treatment, however, no consensus has been reached concerning the best treatment for unresectable MFH. The current study presents the case of a 77-year-old male with MFH of the chest wall. The patient developed a painless mass and intermittent fever over a four-month period. A computed tomography scan demonstrated a large inhomogeneous lesion in the right chest wall, which was subsequently diagnosed via biopsy as a MFH. Since the tumor was an unresectable mass, CyberKnife^® radiotherapy was conducted. Following the treatment, a marked reduction in the tumor size was observed with a tolerable level of toxicity. The sequencing analysis also revealed an in-frame deletion (delE746-A750) in exon 19 of the epidermal growth factor receptor gene. Based on this result, gefitinib was administered to the patient at a dose of 250 mg/day.

Successful treatment of malignant fibrous histiocytoma originating in the chest wall: report of a case

Malignant fibrous histiocytoma (MFH) rarely originates in the chest wall, so its clinical features are not well defined. We report a case of MFH that recurred locally 3 years after primary resection. The patient, a 59-year-old woman, underwent wide excision, and is alive without recurrence 7 months after the operation. We reviewed the clinical features and treatment strategies of the total 39 cases of MFH originating in the chest wall reported from Japan. The fact that all patients who underwent wide excision with negative margins at the primary operation were alive without recurrence at the time of each report, despite a local recurrence rate as high as 40%, shows the importance of this operative strategy. Thus, early diagnosis of MFH of the chest wall is essential for improving the outcome of these patients. Neoadjuvant chemotherapy plus radiation therapy may be worthwhile for patients with advanced disease.

Malignant fibrous histiocytoma of chest wall

Primary malignant fibrous histiocytoma (MFH) of the chest wall is rare. We report a case of primary MFH arising from the chest wall, which was thought to be a metastasis or myeloma. The imaging study revealed a single mass of the chest wall involving a rib. Resection and chest wall reconstruction was done. The histologic diagnosis was storiform-pleomorphic primary MFH. Although MFH of the chest wall is an uncommon pathology, it should be considered in the differentiation of a single bony destructive lesion involving the rib with a soft tissue component.

Primary malignant fibrous histiocytoma of the chest wall: CT and MR appearance

PURPOSE

The purpose of this work is to describe the CT and MR appearance of primary malignant fibrous histiocytoma (MFH) of the chest wall.

METHOD

Eleven men and eight women (45-76 years old) with primary MFH of the chest wall who underwent both CT and MRI were enrolled, and the imaging interpretation was retrospectively compared to the pathologic specimen.

RESULTS

All tumors were inhomogeneous in appearance on CT scans. All tumors showed high signal intensity on T2-weighted images. On T1-weighted MR images, tumors displayed inhomogeneous isosignal intensity in 15 cases (79%) and low signal intensity in 5 (21%) compared with the surrounding muscle. Tumors exhibited inhomogeneous enhancement in all except three localized tumors on enhanced CT and MRI. Invasion of intercostal muscle was noted on MR images in 18 patients (95%) and on CT in 11 patients (58%).

CONCLUSION

There might be various radiologic appearances of MFH. However, CT and MRI are able to demonstrate the exact localization and disease extent of MFH arising in the chest wall.