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一例伴有多器官转移的皮肤恶性纤维组织细胞瘤。

A case of cutaneous malignant fibrous histiocytoma with multiple organ metastases.

机构信息

Department of Geriatric and Environmental Dermatology, Graduate School of Medical, Nagoya City University, Nagoya, Japan.

出版信息

Kaohsiung J Med Sci. 2013 Feb;29(2):111-5. doi: 10.1016/j.kjms.2012.08.019. Epub 2012 Oct 13.

Abstract

Malignant fibrous histiocytoma is a soft tissue sarcoma that most commonly occurs in the extremities and rarely metastasizes cutaneously. A 79-year-old male patient consulted a dermatologist 11 months after recognizing an intractable ulcer on the right mandible. Punch biopsy revealed eosinophilic tumor cells in the dermal area and proliferation of rich spindle cells. Malignant fibrous histiocytoma or atypical fibroxanthoma was suspected and he was referred to our hospital. Red plaque tumors on the right mandible and right temple were 30 mm and 15 mm in size, respectively. The right mandible lesion was ulcerated. Immunohistochemically, the lesions were positive for CD10, CD74 and alpha-smooth muscle actin. Radiological analysis revealed multiple organ metastases, including bone, liver, lung and skin on the right temple. The patient was diagnosed with malignant fibrous histiocytoma, stage IV and died 8 weeks after the first visit due to respiratory failure. Cutaneous malignant fibrous histiocytoma has a poor prognosis resulting in death.

摘要

恶性纤维组织细胞瘤是一种软组织肉瘤,最常发生于四肢,很少发生皮肤转移。一名 79 岁男性患者在发现右侧下颌骨难治性溃疡 11 个月后咨询皮肤科医生。打孔活检显示真皮区有嗜酸性肿瘤细胞和丰富的梭形细胞增殖。怀疑为恶性纤维组织细胞瘤或非典型纤维黄色瘤,并转至我院。右侧下颌骨和右侧颞部有红色斑块肿瘤,分别为 30mm 和 15mm 大小。右侧下颌骨病变有溃疡。免疫组化显示病变阳性表达 CD10、CD74 和 α-平滑肌肌动蛋白。影像学分析显示包括骨、肝、肺和右侧颞部皮肤在内的多个器官转移。该患者被诊断为恶性纤维组织细胞瘤,IV 期,首次就诊后 8 周因呼吸衰竭死亡。皮肤恶性纤维组织细胞瘤预后不良,导致死亡。

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