Primary malignant fibrous histiocytoma of the abdominal cavity: CT findings and pathological correlation

Abstract

AIM:To study computed tomography (CT) �eatures of abdominal malignant fibrous histiocytoma (MFH) in various rare locations. METHODS:We retroprospectively identi�ied cases o� �FH involving the abdominal cavity. �articular attention was paid to details regarding imaging �eatures and histological types. RESULTS:The study population consisted o� seven men and one woman, with a mean age o� 52.5 years. Seven patients had some physical symptoms, while one was incidentally detected. The sites o� origin were liver (n = 3), greater omentum (n = 1), superior mesentery (n = 1), ileum (n = 1), right psoas muscle (n = 1) and right kidney (n = 1). With the exception o� the ileum lesion, all were o� huge size. The contour o� the lesions was more or less clear. Foci o� necrosis were present in six lesions (n = 6). On plain CT scan, all lesions were hypo to iso dense. The lesion in the greater omentum was cystic. One lesion (n = 1) showed signi�icant enhancement and the cystic lesion showed mild peripheral enhancement. An abundance o� blood vessels surrounding the mass was seen in two lesions (n = 2) and both were o� the in�lammatory variety. �athological examination revealed stori�orm-pleomorphic variety (n = 4), inflammatory variety (n = 3) and myxoid variety (n = 1). Two of the patients with inflammatory MFH had a clinical presentation o� �ever and one was a�ebrile, however, blood investigations in all three showed leukocytosis.CONCLUSION: �rimary �FHs o� the abdominal viscera and gastrointestinal tract are generally huge so�t tissue masses containing areas o� low attenuation and mild to moderate contrast enhancement.

Computed tomography and magnetic resonance imaging findings of malignant fibrous histiocytoma of the head and neck

“…However, not all inflammatory MFHs exhibit marked enhancement. Karki et al (21) reported 3 cases of inflammatory MFH, although only 1 case exhibited marked enhancement, whereas the remaining 2 cases exhibited mild enhancement. These different enhancement patterns may be the result of different tumor locations.…”

Management of the “Other” retroperitoneal sarcomas

“…Malignant psoas syndrome is an uncommon condition caused by malignant infiltration of the psoas muscle and adjacent nerves and is characterized by (fixed) flexion deformity of the ipsilateral hip and proximal lumbosacral plexopathy, and this syndrome has been described in the case of UPS of the psoas muscle . The psoas muscle is a rare location for sarcomas, but soft tissue sarcomas originating from it should be managed like other high‐grade extremity and truncal sarcomas (with perioperative radiotherapy+/−chemotherapy) …”

Malignant fibrous histiocytoma in a patient presenting with urinary system symptoms

“…They are divided into five different subgroups and the ones more commonly seen are pleomorphic and myxoid types, which tend to present higher grades, while the rarer giant cell, inflammatory and angiomatoid subtypes tend to present lower grades. 5 The etiology of MFH is not completely known; however, it is more common in patients who received radiotherapy, similar to other sarcomas. In addition, sunlight, chemical agents such as phenacetin, previous surgery, trauma and fracture, bone infarct, and tumors such as Hodgkin lymphoma and multiple melanoma are predisposing factors.…”

“…Heterogeneous contrast enhancement might be seen in post-contrast images secondary to necrotic and hemorrhagic components. 5 Fluid-fluid levels may be seen secondary to hemorrhage in CT and MRI. Signal properties of hemorrhagic component in MRI vary according to the character of the blood products.…”

“…In addition, sunlight, chemical agents such as phenacetin, previous surgery, trauma and fracture, bone infarct, and tumors such as Hodgkin lymphoma and multiple melanoma are predisposing factors. 4,5 Most of the patients are asymptomatic, since the lesion is located retroperitoneally and deeply, or they have nonspecific symptoms such as flank pain, fever and weight loss. C-reactive protein level and erythrocyte sedimentation rate may be found to be increased in laboratory tests.…”