Xu Zhen, Qu Wei, Yu Yonghua
Graduate School, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
Department of Radiation Oncology Ward 2, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academic of Medical Sciences, Jinan, China.
Transl Cancer Res. 2020 Nov;9(11):7350-7358. doi: 10.21037/tcr-20-2297.
Malignant fibrous histiocytoma (MFH) usually involves the extremities. Among MFH, primary giant cell malignant fibrous histiocytoma of the lung is extremely rare, with nonspecific symptoms. A 45-year-old woman was first diagnosed as sclerosing hemangioma due to long-term persistent cough and blood in sputum. One year later, the condition became worse and hemoptysis occurred. At the second visit, the same mass was found to be larger than the previous one. Lobectomy was performed and the primary giant cell MFH of the lung was confirmed. Renal and sacrum metastasis occurred six months after operation. The efficacy of hypofractionation radiotherapy and immuno targeted follow-up therapy is significant. At present, there is no standard treatment plan. For the patients in the early stage, surgical resection is the main treatment method; but for the patients in the middle and late stage, the treatment is relatively single. So early diagnosis and treatment are particularly important, In this paper, we first report the use of pembrolizumab combined with anlotinib in a patient with advanced giant cell MFH of the lung, with failure of routine treatment. The development of the disease had successfully delayed and satisfactory results were observed. Therefore, it is very necessary to emphasize the choice of treatment plan to improve the prognosis of patients.
恶性纤维组织细胞瘤（MFH）通常累及四肢。在MFH中，原发性肺巨细胞恶性纤维组织细胞瘤极为罕见，症状不具特异性。一名45岁女性因长期持续咳嗽和痰中带血最初被诊断为硬化性血管瘤。一年后，病情加重并出现咯血。第二次就诊时，发现同一肿块比之前增大。行肺叶切除术，确诊为原发性肺巨细胞MFH。术后6个月发生肾和骶骨转移。短程放疗和免疫靶向后续治疗疗效显著。目前尚无标准治疗方案。对于早期患者，手术切除是主要治疗方法；但对于中晚期患者，治疗相对单一。因此早期诊断和治疗尤为重要。本文首次报道了帕博利珠单抗联合安罗替尼用于一名常规治疗失败的晚期肺巨细胞MFH患者。成功延缓了疾病进展，观察到满意的结果。因此，强调治疗方案的选择以改善患者预后非常必要。
