Soft Tissue Paraspinal Inflammatory Malignant Fibrous Histiocytoma Presenting as a Lumbar Abscess

Liarmakopoulos, Emmanouil; Lampropoulos, Pavlos; Marinis, Athanasios; Markakis, Charalambos; Manoloudaki, Kassiani; Chatzimarkou, Andreas; Rizos, Spyros

doi:10.1159/000330367

Cited by 3 publications

(8 citation statements)

References 12 publications

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“…These patients frequently present with constitutional symptoms including fever, malaise, weight loss and anorexia in addition to local abdominal discomfort and elevated serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Inflammatory MFH typically shows hypervascularity on the arterial phase of CECT scan with an early wash-out on the venous phase ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging features favoring MFH over abscess include heterogeneous signal on T2-weighted images, and invasion into adjacent soft tissue plane however, definitive diagnosis can be made only by multiple site biopsy ( 3 ). The differential diagnosis for retroperitoneal cystic MFH includes leiomyosarcoma (cystic areas more common), abscess and hematoma formation in the order of importance ( 1 , 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…Wide surgical excision with tumor-free margins remains the principal treatment modality with concurrent chemotherapy and radiation therapy that are needed to reduce the possibility of local recurrence and metastases ( 3 , 6 ). MFH with extensive necrosis has been reported to mimic a benign cystic tumor or abscess ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

“…Malignant fibrous histiocytomas (MFH) arise from primitive mesenchymal elements more commonly in males in the 50 - 60-year age group ( 1 , 2 ). MFH is seen more frequently in the extremities, followed by the abdominal cavity and the retroperitoneum ( 3 ). The iliopsoas compartment is a rare site for soft tissue sarcomas as well as other primary and secondary tumors ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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Retroperitoneal Cystic Malignant Fibrous Histiocytoma Mimicking a Psoas Abscess

et al. 2015

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Primary neoplasms in the psoas muscle including schwannoma and soft tissue sarcoma with secondary cystic degeneration are rare entities. They are difficult to distinguish from psoas abscess purely based on radiological findings. Malignant fibrous histiocytoma (MFH) in the retroperitoneum is an uncommon entity in contrast to liposarcoma and leiomyosarcoma. Psoas abscess is a common infection in the retroperitoneum, especially in regions where tuberculosis is endemic. In the current case, the patient presented with gradually progressive lower abdominal pain and raised erythrocyte sedimentation rate (ESR), lymphocyte count and sputum positive for acid fast bacilli. There was a presence of previous history of skeletal tuberculosis. Imaging revealed well-defined multilocular cystic lesion involving the left psoas muscle which along with the clinical scenario suggested psoas abscess. However, post-operative biopsy showed the lesion to be a MFH with extensive cystic degeneration. To the best of our knowledge, cystic MFH mimicking an abscess has been previously reported only once in an oncology literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retroperitoneal Cystic Malignant Fibrous Histiocytoma Mimicking a Psoas Abscess

et al. 2015

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“…Treatment for this neoplasm remains mostly surgical; however, this approach is often precluded due to the age of the patients, advance stage of the disease at presentation, and comorbidities [ 1 , 2 , 9 , 25 , 27 , 28 ]. This tumor is not completely radiosensitive since relapses with wide spread metastasis have been observed after full courses of radiation, and deep soft tissue metastatic microfoci have been detected in surgical specimens after completion of radiation treatment [ 1 , 9 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Malignant Fibrous Histiocytoma Associated with Leukemoid Reaction or Leukocytosis: A Comprehensive Review

et al. 2012

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Inflammatory malignant fibrous histiocytoma (IMFH) associated with leukemoid reaction (LR)/leukocytosis is a rare entity. In this paper, we search PubMed for all known cases of IMFH associated with LR/leukocytosis in an attempt to draw conclusions about this variant's response to treatments and its pathophysiology. Medline electronic database was searched using key words such as malignant fibrous histiocytoma, leukemoid reaction, and leukocytosis. A total of 16 patients were found, twelve males (75%) and 4 female (25%), with a mean age of 62.6 years, ranging from 47 to 77. The mean survival was 770 days, ranging from 14 to 6570 days. Four patients were alive at last follow-up: 6570 days, 1095 days, 335 days, and 180 days, respectively. Of the 12 patients that expired, death occurred approximately 92 days after the onset of LR or leukocytosis, ranging from 3 to 334 days. We conclude that IMFH associated with LR/leukocytosis does not completely respond to chemoradiation. Overproduction of growth factors and cytokines by IMFH cells and their interactions with the inflammatory infiltrate seem to promote immunological effector cell's dysfunction and substantiate the development and growth of this neoplasm. A clear understanding of these molecular pathways is crucial in order to identify targets for potential therapy.

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A Major Response to Trabectedin in Metastatic Malignant Fibrous Histiocytoma of the Vertebra: A Case Report and Review of the Literature

Sereno

Merino

Aguayo

et al. 2013

Tumori

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Malignant fibrous histiocytoma is an aggressive tumor, the most common soft-tissue sarcoma of adult age. It is usually located in the extremities and retroperitoneum, and very rarely there is skeletal involvement. Surgery is the preferred treatment in early disease; in advanced disease, chemotherapy is the main therapeutic strategy. We present a 25-year-old female patient diagnosed with a vertebral mass in T5 with a severely compromised spinal cord. She underwent surgical decompression and the pathological findings were consistent with malignant fibrous histiocytoma. After several surgical treatments she had pulmonary progression and was therefore started on chemotherapy. She had a very poor response to most of the administered regimens until she initiated trabectedin 1 mg/m 2 every three weeks. She showed a significant improvement with a major response of the lung metastases. This report indicates that trabectedin is an active drug in advanced, previously treated metastatic malignant fibrous histiocytoma.

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Soft Tissue Paraspinal Inflammatory Malignant Fibrous Histiocytoma Presenting as a Lumbar Abscess

Cited by 3 publications

References 12 publications

Retroperitoneal Cystic Malignant Fibrous Histiocytoma Mimicking a Psoas Abscess

Retroperitoneal Cystic Malignant Fibrous Histiocytoma Mimicking a Psoas Abscess

Inflammatory Malignant Fibrous Histiocytoma Associated with Leukemoid Reaction or Leukocytosis: A Comprehensive Review

A Major Response to Trabectedin in Metastatic Malignant Fibrous Histiocytoma of the Vertebra: A Case Report and Review of the Literature

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