Adjuvant chemotherapy for treatment of unresectable and metastatic angiomatoid malignant fibrous histiocytoma

Abstract

Angiomatoid malignant fibrous histiocytoma (AMFH) is a low grade soft tissue sarcoma usually treated with surgery alone. Only one adult patient has been treated with systemic chemotherapy. The authors report a case of unresectable, metastatic AMFH treated initially with vincristine, doxorubicin, dactinomycin, and cyclophosphamide. A complete response at the metastatic site and a marked reduction in the size of the primary tumor allowed complete surgical excision 7 months after treatment was initiated. The patient remains disease free 19 months after being diagnosed. It was concluded that systemic chemotherapy may be effective in patients with AMFH.

Orthopaedic Case of the Month: A 14-Year-Old Boy With a Medial Thigh Soft Tissue Mass

“…In patients with an unresectable or recurrent tumor, adjuvant radiotherapy or chemotherapy may be indicated [15]. Chemotherapy is not indicated for resectable cases [6,15]. Local recurrence rates vary from 0% to 63% [10,11,[18][19][20]23].…”

Angiomatoid fibrous histiocytoma: A case of local recurrence and metastases to loco‐regional lymph nodes that responded to chemotherapy

“…Chemotherapy has previously been used successfully in one case in which a 9‐year‐old female presented with an unresectable inguinal tumour and a metastatic bone lesion. In this case, vincristine, doxorubicin, dactinomycin and cyclophosphamide were used leading to a complete response of the metastasis and reduction in the primary tumour allowing for surgical excision . This case report confirms that AFH responds to chemotherapy and may particularly benefit patients with unresectable and metastatic disease.…”

“…We report the case of a 6‐year‐old male who presented with recurrent AFH and loco‐regional lymph node metastases following previous resection, which has responded well to chemotherapy. This is the second reported case in literature that demonstrates chemotherapy being used successfully …”

Malignant Fibrous Histiocytoma of the Spine

“…MHF of bone is treated identically to the osteosarcoma, with multiagent neoadjuvant chemotherapy (doxorubicin and cisplatin). 20,21,46,47 The most common site of the fi rst manifestation of metastatic spread i s the lungs, whereas the bone, liver, and skin are less frequent. Tumor size has also been shown to correlate with the clinical behavior of soft tissue MFH in the literatures, with a 57% metastasis rate in tumors greater than10 cm in diameter.…”