Malignant Fibrous Histiocytoma of the Renal Capsule

Abstract

A 49-year-old female discovered a tumour in her abdomen shortly before being admitted to hospital. Her previous history was uneventful.Examination revealed a mobile, large, hard tumour in the right hypogastric region. Haematological and biochemical tests, chest X-ray and bone scan showed no abnormalities. Intravenous urography showed normal structures on the left side but on the right only the upper calices appeared normal. The rest of the renal pelvis was obscured by a 12-cm turnour. Sonography identified a 9 x 12 cm tumour, partly filled with liquid, originating from the lower pole of the right kidney, and a 1.5 cm lesion in the left hepatic lobe. Computed tomography confirmed the haemangioma of the liver and a solid tumour with central necrosis and cranial displacement of the kidney. Angiography showed the lesion in the kidney to have a pathological vessel pattern and non-hornoge-

Primary Renal Malignant Fibrous Histiocytoma

“…In a review of the international literature based basically on Medline, we revealed reports of only 23 patients with documented diagnosis of primary renal MFH in the period 1974-1997 [7,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] and to this we add our recent case. The above-mentioned patients ranged in age from 35 to 82 years and mean age of 59 years.…”

“…The majority of the cases occurs in the trunk, the extremities and the retroperitoneum [1,2]. Primary involvement of the retroperitoneum or kidney is rare and accounts for 12-14% of all MFH cases [7], whilst it composes only 1-3% of malignant renal tumors in general [15,16].…”

“…The majority of cases affect limb structures, the abdomen and retroperitoneum [1,2]. Primary involvement of the retroperitoneum or kidney is very rare and accounts for 12-14% of all cases [7]. There are also reports on MFH of the bladder [8], spermatic cord [9] and penis [10].…”

Primary malignant fibrous histiocytoma of the kidney: report of a case and literature review

“…[13,16,17] Because most renal MFHs arise from the capsule, intracavitary progression and consecutive hematuria are rare. [13,18,19] Symptoms, a physical examination, and imaging are insufficient for differentiating MFH from other renal tumors, and histopathology is essential for its differentiation. [18][19][20][21] MFH is a common type of soft tissue sarcoma that was initially described four decades ago, and it has been shown to have the characteristics of both mesenchymal cells and mononuclear phagocytes [22][23][24] The most common renal sarcomas are characterized by typical immunophenotypes that include negativity for CD68.…”

“…The role of adjuvant radiotherapy is questionable and offers little, if any, benefit. [14,18,19,21] Only early radical surgery and postoperative polychemotherapy can achieve success. [13,20] If local infiltration or distant metastases are present, treatment with polychemotherapy may be indicated, although the effectiveness is questionable and the response rate is only 33%.…”