Malignant fibrous histiocytoma of the stomach: Report of two cases

Abstract

Malignant fibrous histiocytoma (MFH) in the stomach is very rare, and only four cases have been reported. As a result, there is still little understanding of its clinical and pathological features. We recently experienced two cases of gastric MFH. The first case was a 78-year-old man with epigastralgia and a loss of body weight. Endoscopy revealed an ulcerated submucosal tumor. A gastrectomy was performed and the diagnosis of MFH was made histopathologically. The second case was a 77-year-old man with pulmonary symptoms. An image diagnosis indicated a strong suspicion of lung cancer, and a right middle and lower lobectomy was thus performed. One month after the operation, a bleeding gastric tumor was found and therefore a gastrectomy was performed. Both tumors were diagnosed as MFH. From the analysis of six reported cases including ours, a preoperative correct diagnosis is found to be difficult although the lesion has grown to a considerable size at the time of operation. Since a metastatic lung lesion was first detected in two out of six cases, it is thus recommended that the stomach should be examined when lung MFH is found. Considering the high mortality and the short survival in the six cases, the prognosis for gastric MFH seems to be poorer than that in the extremities. However, lymph node metastasis is uncommon, and a curative resection is possible in some cases such as in our second case.

Malignant Fibrous Histiocytoma of the Ileum at a Site of Previous Surgery: Report of a Case

“…[1][2][3][4][5][6][7][8] Several authors have discussed a possible promoting role of chronic repair processes in the tumorigenesis of malignant fibrous histiocytomas arising at different sites. [9][10][11][12][13][14][15][16][17] Intestinal malignant fibrous histiocytomas have been found associated with a history of pelvic radiotherapy 7,18 and, in one case, with diverticulitis.…”

Primary and metastatic high-grade pleomorphic sarcoma/malignant fibrous histiocytoma of the gastrointestinal tract: an approach to the differential diagnosis in a series of five cases with emphasis on myofibroblastic differentiation

“…As the majority of them have preceded the era of sub-classifying pleomorphic STS, it is likely that a considerable fraction of previous reports might have represented pleomorphic variants of other specific sarcoma types. The clinical features and the biological course of primary GI MFH are comparable to their soft tissue counterparts [33,41,42]. Symptoms were generally non-specific, but signs of GI bleeding are common.…”

“…Previously, reported primary MFH of the GI tract involved the small and large bowel more frequently and only rarely the stomach [22,33,41,42,44]. As the majority of them have preceded the era of sub-classifying pleomorphic STS, it is likely that a considerable fraction of previous reports might have represented pleomorphic variants of other specific sarcoma types.…”

“…Primary and metastatic MFH is rare in the gastrointestinal (GI) tract with ≈50 primary [33,41,42,44] and five metastatic cases reported from different parts of the GI tract, usually as single case reports [1,6,9,22,33,[39][40][41][42]44]. In this study, we describe and compare the clinicopathological and immunohistochemical features of two primary gastric MFH and three metastatic MFH involving the small and large bowel and discuss their broad differential diagnosis with a reference to myofibroblastic differentiation.…”

Gastric metastasis of malignant fibrous histiocytoma diagnosed preoperatively by endoscopic ultrasound-guided fine-needle aspiration biopsy: Report of a case

“…[1][2][3][4][5][6] Metastatic gastric MFH is very rare, and tends to be found as submucosal tumors covered by normal mucosa. 7 Therefore, they can be diffi cult to diagnose preoperatively.…”