Hsiao Po-Jen, Chen Guang-Heng, Chang Yi-Huei, Chang Chao-Hsiang, Chang Han, Bai Li-Yuan
Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan, R.O.C.
Department of Pathology, China Medical University Hospital, Taichung 40447, Taiwan, R.O.C.
Oncol Lett. 2016 Apr;11(4):2403-2407. doi: 10.3892/ol.2016.4283. Epub 2016 Feb 25.
Malignant fibrous histiocytoma (MFH) is most commonly observed in the extremities and the trunk but rarely in retroperitoneum. The present case report documents a 64-year-old man who was admitted with an abdominal palpable mass for 6 months. After a thorough investigation, a tumor of the retroperitoneum was identified adhered to adjacent organs and vessels. The patient experienced mild hydronephrosis and hydroureter as a result of the tumor compression. A number of previous surgeons considered the tumor unresectable and suggested palliative treatment. resection of the tumor was attempted but incomplete surgery was performed initially as the tumor was friable and prone to bleeding. Therefore, a biopsy of the tumor was performed and a double J ureteral stent was set for hydronephrosis. Histopathological examination confirmed the tumor was an MFH. The patient received neo-adjuvant chemotherapy with 4 cycles of mesna, doxorubicin, ifosfamide, and dacarbazine (MAID). A computed tomography scan demonstrated that the tumor had reduced in size following chemotherapy. E resection of the tumor was arranged again 6 months later. The tumor exhibited a complete response to neo-adjuvant chemotherapy after the formal pathological evaluation. The patient survives without tumor recurrence >5 years without recurrence.
恶性纤维组织细胞瘤（MFH）最常见于四肢和躯干，但很少发生于腹膜后。本病例报告记录了一名64岁男性，因腹部可触及肿块6个月入院。经过全面检查，发现腹膜后有一个肿瘤，与相邻器官和血管粘连。由于肿瘤压迫，患者出现轻度肾盂积水和输尿管积水。此前多位外科医生认为该肿瘤无法切除，并建议进行姑息治疗。尝试切除肿瘤，但最初手术不完整，因为肿瘤质地脆且容易出血。因此，对肿瘤进行了活检，并为肾盂积水置入了双J输尿管支架。组织病理学检查证实肿瘤为MFH。患者接受了4个周期的美司钠、多柔比星、异环磷酰胺和达卡巴嗪（MAID）新辅助化疗。计算机断层扫描显示化疗后肿瘤体积缩小。6个月后再次安排切除肿瘤。经过正式病理评估，肿瘤对新辅助化疗表现出完全反应。患者存活超过5年无肿瘤复发。
