Clinical characteristics of the primary hepatic malignant fibrous histiocytoma in China: case report and review of the literature

Abstract

BackgroundA malignant fibrous histiocytoma is a soft tissue tumor that most commonly occurs in the extremities, but rarely involves the liver. The clinical characteristics and therapeutic experiences of primary hepatic malignant fibrous histiocytoma are still limited.MethodsTwo cases of primary hepatic malignant fibrous histiocytoma were analyzed retrospectively, and all the literature concerning primary hepatic malignant fibrous histiocytoma was analyzed.ResultsIn China, a total of 76 cases had been reported, among which 50 were men, with a male to female ratio of 1.9:1. Mean age of the patients was 51.0 years old, and more than 85 percent were older than 40 years. 82.9 percent (63/76) of hepatic MFH were solitary lesions, with tumor size ranging from 2.5 to 23.5 cm (average 10.3 cm). Major clinical presentation (78.4%) was abdominal pain or discomfort, accompanied with some other non-specific symptoms such as malaise, anorexia, weight loss, jaundice and fever, and small cases (14.9%) were asymptomatic. Computed tomography and ultrasound usually revealed the location of lesions. The rate of pre-operative misdiagnosis was extremely high, and 14.9 percent of patients were even misdiagnosed as a benign liver cyst, liver abscess or hematoma. Integrated resection was performed among the most cases (49/68), among which only a few ones (12 cases) were introduced to have no recurrence or metastasis or be still alive with no detail information provided, while among the cases with palliative operation or only a biopsy, the cases that were followed-up all died.ConclusionsHepatic malignant fibrous histiocytoma is a rare malignant mesenchymal tumor. The variable features of clinical presentations and images make the diagnosis difficult. Though the prognosis of primary hepatic malignant fibrous histiocytoma was rather poor, integrated resection might provide a few cases a good opportunity for surviving, suggesting that surgery might be an effective treatment.

Primary hepatic malignant fibrous histiocytoma combined with invasion of inferior vena cava

“…Ten literatures were eligible, [3,6,9–16] which contained 41 cases of hepatic MFH with overall survival (Table 1). Among the 41 cases confirmed pathologically, there were 23 males and 18 females.…”

Primary giant cell malignant fibrous histiocytoma-associated with renal calculus

“…3,4 Some cases in the kidneys, prostate, urinary bladder, spermatic cord, liver, pancreas, thyroid and breast were rarely reported. 2,[5][6][7][8][9][10][11] There are 4 defined histomorphological patterns of MFH: (1) storiform-pleomorphic subtype, (2) myxoid subtype, (3) giant cell subtype and (4) inflammatory subtype (in order of frequency). Giant cell subtypes are lesions consisting of widespread hemorrhagic and necrotic areas histologically characterized by numerous multinuclear osteoclast-type giant cells.…”

Abdominal bleeding due to ruptured primary hepatic malignant fibrous histiocytoma

“…Primary MFH of the liver is rare accounting for less than 1% of primary hepatic malignancies according to Liver Cancer Study Group of Japan and since the first report in the literature in 1985, a limited number of cases have been published [1][2][3][4][5][6][7][8][9][10][11][12][13]. The clinical presentation of primary hepatic MFH miscellaneous and nonspecific varies as there are asymptomatic cases while others present with symptoms which are common in a variety of diseases [8,13]. This lack of specific symptoms is the main reason of the high incidence for the pre-operative misdiagnosis of MFH [13].…”

“…The clinical presentation of primary hepatic MFH miscellaneous and nonspecific varies as there are asymptomatic cases while others present with symptoms which are common in a variety of diseases [8,13]. This lack of specific symptoms is the main reason of the high incidence for the pre-operative misdiagnosis of MFH [13]. The clinical-pathology of primary hepatic MFH is far to be well understood.…”

“…The clinical-pathology of primary hepatic MFH is far to be well understood. Histologically, MFH is composed of a heterogeneous group of tumors with the most commonly found form, the pleomorphic variant with spindle cells in a storiform pattern [4,7,9,[11][12][13][14][15]. Our patient was managed by extended hepatectomy.…”