Wang Zhen, Wu Xin-Hu, Li Bing, Kong Qing-Tao, Shen Ze-Tian, Li Jing, Liu Zhi-Bing, Zhu Xi-Xu
Department of Radiation Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, P.R. China.
Department of Dermatology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, P.R. China.
Oncol Lett. 2014 Jun;7(6):1877-1880. doi: 10.3892/ol.2014.1995. Epub 2014 Mar 24.
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.
恶性纤维组织细胞瘤（MFH）是最常见的软组织肉瘤类型，但很少起源于胸壁。手术切除被认为是最可靠的治疗方法，然而，对于不可切除的MFH的最佳治疗方法尚未达成共识。本研究报告了一例77岁男性胸壁MFH病例。患者在四个月的时间里出现无痛性肿块和间歇性发热。计算机断层扫描显示右胸壁有一个大的不均匀病变，随后经活检诊断为MFH。由于肿瘤是不可切除的肿块，因此进行了射波刀放射治疗。治疗后，观察到肿瘤大小明显缩小，毒性水平可耐受。测序分析还显示表皮生长因子受体基因第19外显子存在框内缺失（delE746-A750）。基于这一结果，给予患者吉非替尼，剂量为250mg/天。
