Malignant Fibrous Histiocytoma of the Heart: Case Report and Review of 46 Cases in the Literature.

Abstract

A rare case of cardiac malignant fibrous histiocytoma (MFH)is reported. A 55-year-old womancomplained of palpitation due to atrial fibrillation. Echocardiography, magnetic resonance imaging, and angiography demonstrated a tumor arising from the posterior wall of the left atrium. At surgery, the tumor was almost entirely resected and histologically defined as MFH.Neither chemotherapy nor irradiation was administered. Echocardiography revealed a local recurrence two months after the surgery and the patient died of advanced cachexy and heart failure 2 years later. The details of this case are presented with a review of the literature.

Primary malignant fibrous histiocytoma of the heart

“…As seen by UCG, a nonseptal origin, multiple attachment sites, and infiltration of the mitral valve or atrial wall (or both) were indicative of malignancy. 3,5 In our case, two attachments were observed by preoperative UCG, suggesting the malignant potential of these tumors. Therefore, thorough evaluation of distal metastasis by CT was performed preoperatively.…”

“…1 The first case of cardiac MFH was reported by Shah et al 2 in 1978; and 47 cases have since been reported in the literature. 3,4 According to a thorough analysis of the reported cardiac MFH cases by Okamoto et al, the patients' ages ranged from 17 to 77 years, with 62% of the patients female. The most common location of the MFH was the The patient was discharged 15 days after the operation in good condition, and UCG was repeated every 2-3 months.…”

“…A distant metastasis in the pancreatic tail, 3 cm in diameter, was detected by CT. A third palliative operation was performed to ameliorate LA, and it was usually attached to the posterior wall (81%), as was the tumor in our case. 3 Making a distinction between a benign and a malignant lesion is extremely difficult on a clinical basis. As seen by UCG, a nonseptal origin, multiple attachment sites, and infiltration of the mitral valve or atrial wall (or both) were indicative of malignancy.…”

A Unique Case of Rapidly Progressive Diffuse Pulmonary Nodules

“…In one review of 47 cases, dyspnea was the most common presenting complaint (74%) followed by heart palpitations or chest discomfort (40%) [10]. Our case is unique in that the local tumor in the right ventricle remained relatively small while the lung parenchyma was almost entirely invaded by tumor emboli.…”

“…Surgical resection with clear margins is the treatment of choice for localized tumors. In addition, surgical resection is necessary to ameliorate symptoms and to obtain a histologic diagnosis despite a high incidence of local recurrence and distant metastasis [10]. Due to the aggressive nature of this tumor, the average survival time is less than one year [13].…”