Primary hepatic malignant fibrous histiocytoma mimicking hepatocellular carcinoma: A report of two cases

Abstract

Malignant fibrous histiocytoma (MFH) is a tumor that occurs throughout the body as a relatively uncommon entity. The current study presents two cases of primary malignant fibrous histiocytoma of the liver. The first case was of a 67-year-old male who exhibited no symptoms or abnormal physical signs, and in whom the lesion was found by ultrasound examination during a routine physical examination. The second case was of a 35-year-old male who presented with persistent malaise, weight loss and intermittent right upper quadrant pain. The presence of liver cirrhosis due to hepatitis B virus, which was identified 10 years previously, and the clinical appearance caused MFH to appear as hepatocellular carcinoma at the time of the initial diagnosis. Abdominal magnetic resonance imaging scans were the main tools of diagnosis, but the MFH mimicked hepatocellular carcinoma due to the similar morphological characteristics, the rare occurrence of MFH and the underlying diseases of the liver. The first patient underwent a complete resection and recovered well, while the second patient underwent palliative treatment due to the large size of the tumor and the obstructive emboli in the portal vein. The diagnoses of the tumors were confirmed as MFH by histopathology and immunohistochemistry.

Clinical and imaging characteristics of primary hepatic sarcomatoid carcinoma and sarcoma: a comparative study

“…The sarcomatous component comprises poorly differentiated cells that grow rapidly with the neovasculature unable to adequately supply the fast-growing malignant cells, resulting in necrosis. The PHSs generally present isoor hypo enhancement on the AP and persistent or progressive enhancement on the later phase, similar to previous studies (12,25). The myxoid degeneration and the loose arrangement of the cells in PHSs could expand the extracellular space and the contrast agent in the extracellular space were accumulated gradually and expurgated slowly, leading to hypo-iso continuous or progressive enhancement.…”

“…Similar to previous study (3,12,13,20), the PHSCs and PHSs demonstrate hypovascularity probably for hemorrhage, necrosis, brous tissue or myxoid degeneration (21)(22)(23)(24). However, the AP enhancement and dynamic enhancement pattern were signi cantly different.…”

“…The current literature on these tumors is limited to either case reports or small case series (11)(12)(13)(14)(15), and no reports were available on the comparison of these two tumors, except a mention by Mani,H (16).…”

Rare hepatic malignant tumors: dynamic CT, MRI, and clinicopathologic features: with analysis of 54 cases and review of the literature

“…Hepatic MFH usually occurs in men between 50 and 60 years of age. The 2-year survival rate is approximately 60%, and 20% suffers from local recurrence [30]. We had even cases of hepatic MFH, the mean age was 44 years, there was a slight male predominance (4/7), and the mean survival time was 15 months.…”

Primary malignant fibrous histiocytoma of the colon: A case report and review of the literature

“…The risk of local recurrence and distant metastasis correlates with the depth and size of the primary tumor (11). The overall 2-and 5-year survival rates for MFH are ~60 and 47%, respectively (4).…”