Interleukin-8 Producing Malignant Fibrous Histiocytoma with Prolonged Fever

Abstract

We present a case of malignant fibrous histiocytoma accompanied by prolonged spiking fevers, which disappeared after tumor resection. Sarcoma with fever as a primary symptom is rare. Furthermore, in this case, fever was closely related to the clinical course of the tumor. In order to detect possible production of febriferous substance(s), we used blood and tumor tissue samples to investigate nine candidate cytokines possibly responsible for the fever. Expression of IL-8 mRNA was detected in preoperative peripheral blood mononuclear cells by RT-PCR. Expressions of IL-6, IL-8, IFN- and TNF- mRNAs were also detected in tumor tissue, while IL-1, IL-1, IL-2, IL-4 and COX-2 mRNAs were not. We suspected IL-8 to be a causative factor, and examined its localization by immunohistochemical staining, paraffin sections of tumor tissue stained positive for IL-8. Since infiltrating mononuclear cells were positive for IL-8, this may explain the tumor-associated fever. This case involves intratumoral production of IL-8 as a causative factor, and IL-6, IL-8, IFN- and TNF- cytokine production might have resulted from stimulation with a substance(s) derived from tumor tissue, since the fever disappeared postoperatively. To date the patient is alive and in good health for 7 years and 2 months since the surgery.

Cutaneous Inflammatory Malignant Fibrous Histiocytoma Presenting with a Leukemoid Reaction: A Case Report and Review of the Literature

“…Since infiltrating mononuclear cells as well as malignant cells were positive for IL-8, this may explain the tumor-associated fever. This observation is supported by other researchers' descriptions of fever resolution after surgical removal of the tumor and its reemergence once the malignancy has relapsed [4, 6, 7]. …”

Neoplastic fever in patients with bone and soft tissue sarcoma

“…Neoplastic fever is relatively rare in patients with bone and soft tissue sarcomas, with only few cases reported to date (18)(19)(20)22). In the present study, neoplastic fever occurred in 11 of 195 patients with bone and soft tissue sarcomas (5.5%).…”

“…Neoplastic fever is a paraneoplastic syndrome that is encountered in 5% of cancer patients (17). There have been a few case reports on neoplastic fever among patients with bone and soft tissue sarcomas (18)(19)(20). The purpose of the present study was to investigate the occurrence of febrile episodes defined as neoplastic fever in patients with bone and soft tissue sarcomas during treatment and follow-up.…”

Malignant Fibrous Histiocytoma of the Spine

“…As the fever promptly disappeared after surgery, it was reasonable to conclude that febriferous substance(s) in tumor tissues were closely associated with the fever in this special case. 29 There has been no report on fever in regard to MFH of the spine to date, although it was reported in the soft tissue of MFH. [30][31][32] The apparent radiographic feature of the MFH in the spine was the osteolytic destruction of the vertebrae without periosteal reaction or new bone formation.…”