Kim Beom Gyu, Chang In Taik, Park Jun Seok, Choi Yoo Shin, Kim Gi Hyeon, Park Eon Sub, Choi Chang Hwan
Department of Surgery, Chung-Ang University College of Medicine, Chung-Ang University, 224-1 Heukseok_Dong, Dongjak-Gu, Seoul 156-755, Korea.
World J Gastroenterol. 2008 Mar 7;14(9):1459-62. doi: 10.3748/wjg.14.1459.
Malignant fibrous histiocytoma, which is composed of spindle-shaped cells arranged in a pleomorphic and storiform pattern, is rarely found in the colorectum. Although complete surgical excision remains the main stem of therapy, an optimal treatment strategy according to the stage has not been elucidated. We report a case of a 63-year-old woman with an ulcerative lesion in the anorectal junction and a final diagnosis of malignant fibrous histiocytoma. We introduced an access for transanal local excision and adjuvant radiotherapy because the patient refused abdominoperineal resection. No local recurrences or distant metastases were observed 15 mo after the operation. To our knowledge, this is the first case reported in the English literature of a malignant fibrous histiocytoma treated with the transanal local excision and adjuvant radiotherapy. This report showed that this approach is selectively reserved for early-stage malignant fibrous histiocytoma and for those patients who refuse radical surgery because of the risk in a permanent colostomy.
恶性纤维组织细胞瘤由呈多形性和车辐状排列的梭形细胞组成，在结直肠中很少见。尽管完整的手术切除仍然是主要的治疗方法，但尚未阐明根据分期的最佳治疗策略。我们报告一例63岁女性，其在肛管直肠交界处有溃疡性病变，最终诊断为恶性纤维组织细胞瘤。由于患者拒绝腹会阴切除术，我们采用了经肛门局部切除及辅助放疗的方法。术后15个月未观察到局部复发或远处转移。据我们所知，这是英文文献中首例经肛门局部切除及辅助放疗治疗恶性纤维组织细胞瘤的病例报告。该报告表明，这种方法适用于早期恶性纤维组织细胞瘤以及那些因永久性结肠造口术风险而拒绝根治性手术的患者。
