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Das lokal rezidivierende maligne fibröse Histiozytom der Niere oder des Samenstrangs

Locally recurrent malignant fibrous histiocytoma of the kidney and spermatic cord

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Zusammenfassung

Ziel

In dieser Untersuchung wurden 26 Patienten mit dem Lokalrezidiv eines malignen fibrösen Histiozytoms von Niere oder Samenstrang nach initialer R0-Resektion im Hinblick auf die Therapiemaßnahmen und die Prognose ausgewertet.

Patienten und Methode

Aus der gemäß einer PubMed-Recherche verfügbaren internationalen Literatur identifizierten wir 24 Fälle eines lokal rezidivierenden malignen fibrösen Histiozytoms der Niere oder des Samenstrangs nach initialer R0-Resektion. Zwei weitere eigene Patienten wurden hinzugefügt und anschließend das gesamte Krankengut hinsichtlich des Zeitraums bis zum ersten Lokalrezidiv und der Gesamtüberlebensrate analysiert.

Ergebnisse

Das mediane Patientenalter betrug 58 Jahre. In 17 Fällen (65%) war die linke Seite betroffen. Nach Primärtherapie war die 5-Jahres-Überlebensrate 25%. Eine adjuvante Therapie wies keine signifikante Verbesserung der Überlebenszeit auf (p=0,259). Das Lokalrezidiv wurde im Durchschnitt nach 13 Monaten (Median: 12 Monate) festgestellt. Die Prognose des malignen fibrösen Histiozytoms nach Detektion des Lokalrezidivs war außerordentlich schlecht. Nur 4 der 26 Patienten überlebten den Zeitraum von 3 Jahren. Die 1-, 2- und 5-Jahres-Überlebensraten waren dann 34%, 28% bzw. 14%. Die mittlere Überlebenszeit betrug 31 Monate bei einem medianen Überleben von 9 Monaten. Patienten mit einem lokal rezidivierenden malignen fibrösen Histiozytom des Samenstrangs besaßen eine signifikant bessere Überlebensprognose als Patienten mit dem Lokalrezidiv eines renalen malignen fibrösen Histiozytoms (p=0,04).

Schlussfolgerung

Maligne fibröse Histiozytome des Urogenitaltrakts sind seltene Malignome mit einer hohen Lokalrezidivrate. Bei fehlender Fernmetastasierung kann aus der R0-Resektion eine kurative Zielsetzung erwachsen. Trotzdem ist die Prognose dieser Erkrankung schlecht, selbst bei frühzeitiger Diagnose des lokalen Therapieversagens und prompt initiierter aggressiver Salvagetherapie bleibt ein Langzeitüberleben selektierten Fällen vorbehalten. Patienten mit einem malignen fibrösen Histiozytom der Niere oder des Samenstrangs benötigen eine lebenslange Nachsorge.

Abstract

Objective

In this study, 26 patients with locally recurrent malignant fibrous histiocytoma of the kidney and spermatic cord after initial R0 resection were reviewed with regard to therapeutic options and prognosis.

Patients and methods

Based on a literature query in the PubMed database, we identified 24 cases with locally recurrent malignant fibrous histiocytoma of the kidney and spermatic cord after initial R0 resection. Two of our own patients were included and afterwards the entire patient group was analyzed with regard to the time period of the first local recurrence and the overall survival rate.

Results

The average patient age was 58 years; in 17 cases (65%) the left side was affected. After primary therapy the 5-year survival rate was 25%; adjuvant therapy did not achieve any significant improvement in survival time (p=0.259). The local recurrence was on average diagnosed after 13 months (with a median of 12 months). The prognosis of malignant fibrous histiocytoma after detection of the local recurrence was extraordinary poor, only 4 of 26 patients survived for longer than 3 years. The 1-, 2- and 5-year survival rates then were 34%, 28%, and 14%, respectively. The mean survival time was 31 months with a median survival of 9 months. Patients with a locally recurrent malignant fibrous histiocytoma of the spermatic cord showed a significant better survival prognosis than patients with a local recurrence of a renal malignant fibrous histiocytoma (p=0.04).

Conclusion

Malignant fibrous histiocytoma of the genitourinary tract are rare tumors with a high rate of local recurrence. If there are no distant metastases a R0 resection can result in a curative objective. Nevertheless, the prognosis of this disease is poor. Even early detection of local therapy failure and promptly initiated aggressive salvage therapy may offer the chance of long-term survival only in selected cases. Lifelong follow-up is necessary for patients with a malignant fibrous histiocytoma of the kidney or spermatic cord.

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Literatur

  1. Adolphs HD, Helpap B, Koischwitz D (1982) Retroperitoneal and inguinal manifestation of malignant fibrous histiocytoma. Urology 20/6: 639–645

    Google Scholar 

  2. Coindre JM, Mariani O, Chibon F et al. (2003) Most malignant fibrous histiocytomas developed in the retroperitoneum are dedifferentiated liposarcomas: a review of 25 cases initially diagnosed as malignant fibrous histiocytoma. Mod Pathol 16/3: 256–262

    Google Scholar 

  3. Cole AT, Straus FH, Gill WB (1972) Malignant fibrous histiocytoma: an unusual inguinal tumor. J Urol 107/6: 1005–1007

    Google Scholar 

  4. Ehrlich RM, Tannenbaum M, Fish GW (1967) The application of new scientific techniques in studying urological neoplasia. J Urol 98: 120–124

    CAS  PubMed  Google Scholar 

  5. Fagundes HM, Lai PP, Dehner LP et al. (1992) Postoperative radiotherapy for malignant fibrous histiocytoma. Int J Radiat Oncol Biol Phys 23/3: 615–619

    Google Scholar 

  6. Froehner M, Manseck A, Haase M, Hakenberg OW, Wirth MP (1999) Locally recurrent malignant fibrous histiocytoma: a rare and aggressive genitourinary malignancy. Urol Int 62/3: 164–170

    Google Scholar 

  7. Fujito S, Kanemura M, Shoji F, Yokoyama M, Nanjou F (1991) Malignant fibrous histiocytoma of the spermatic cord: report of a case. Urol Surg Jpn 4: 97–100

    Google Scholar 

  8. Grignon DJ, Ayala AG, Ro JY, el-Naggar A, Papadopoulos NJ (1990) Primary sarcomas of the kidney. A clinicopathologic and DNA flow cytometric study of 17 cases. Cancer 65/7: 1611–168

    Google Scholar 

  9. Hansen CP, Jensen LM, Holten I (1989) Malignant fibrous histiocytoma of the kidney. Eur Urol 16/5: 395–397

    Google Scholar 

  10. Igarashi J, Asoka H, Nogaki J et al. (1982) Malignant fibrous histiocytoma of the renal fibrous capsule. Jpn J Clin Oncol 36: 1141–1144

    Google Scholar 

  11. Inoue H, Okada S, Hongo Y et al. (1990) Malignant fibrous histiocytoma arising from the renal capsule: report of a case. Hinyokika Kiyo 36/1: 45–50

    Google Scholar 

  12. Ito H, Watanabe T, Okita K (1987) Spermatic cord malignant fibrous histiocytoma, a case report. Jpn J Urol 78: 386–387

    Google Scholar 

  13. Kageyama S, Satoh S, Ihara H eet al. (1991) A case of locally recurrent malignant fibrous histiocytoma of the spermatic cord treated with CYVADIC chemotherapy. Urol Surg Jpn 4: 835–837

    Google Scholar 

  14. Kearney MM, Soule EH, Ivins JC (1980) Malifnant fibrous histiocytoma: a retrospective study of 167 cases. Cancer 45/1: 167–178

    Google Scholar 

  15. Le Doussal V, Coindre JM, Leroux A et al. (1996) Prognostic factors for patients with localized primary malignant fibrous histiocytoma: a multicenter study of 216 patients with multivariate analysis. Cancer 77/9: 1823–1830

    Google Scholar 

  16. Lin BT, Harvey DA, Medeiros LJ (2002) Malignant fibrous histiocytoma of the spermatic cord: report of two cases and review of the literature. Mod Pathol 15/1: 59–65

    Google Scholar 

  17. Matsumoto S, Ahmed AR, Kawaguchi N, Manabe J, Matsushita Y (2003) Results of surgery for malignant fibrous histiocytomas of soft tissue. Int J Clin Oncol 8/2: 104–109

    Google Scholar 

  18. 0’Brien JE, Stout AP (1964) Malignant fibrous xanthomas. Cancer 17: 1445–1455

    CAS  Google Scholar 

  19. Patel SR, Vadhan-Raj S, Burgess MA et al. (1998) Results of two consecutive trials of dose-intensive chemotherapy with doxorubicin and ifosfamide in patients with sarcomas. Am J Clin Oncol 21/3: 317–321

    Google Scholar 

  20. Pezzi CM, Rawlings MS Jr, Esgro JJ, Pollock RE, Romsdahl MM (1992) Prognostic factors in 227 patients with malignant fibrous histiocytoma. Cancer 69/8: 2098–2103

    Google Scholar 

  21. Raghavaiah NV, Mayer RF, Hagitt R, Soloway MS (1980) Malignant fibrous histiocytoma of the kidney. J Urol 123/6: 951–953

    Google Scholar 

  22. Sato K, Noguchi S, Iwasaki A, Ishizuka E (1988) Malignant fibrous histiocytoma of the spermatic cord associated with bladder cancer. Jpn J Urol 50: 1041–1043

    Google Scholar 

  23. Scriven RR, Thrasher TV, Smith DC, Stewart SC (1984) Primary renal malignant fibrous histiocytoma: a case report and literature review. J Urol. 131/5: 948–949

    Google Scholar 

  24. Singh EO, Barrett DM, Adams VI (1982) Synchronously occurring malignant fibrous histiocytoma of the kidney with contralateral renal cell carcinoma. J Urol 128/3: 586–588

    Google Scholar 

  25. Srinivas V, Sogani PC, Hajdu SI, Whitmore WF Jr. (1984) Sarcomas of the kidney. J Urol 132/1: 13–16

    Google Scholar 

  26. Takashi M, Murase T, Sobajima T et al. (1983) A case of malignant fibrous histiocytoma occurring in the retroperitoneum with giant pyonephrosis. Hinyokika Kiyo 29/8: 911–919

    Google Scholar 

  27. Tanaka T, Akazawa N, Ozaki Y, Matsumura Y, Ohmori H (1984) Malignant fibrous histiocytoma originating in the left spermatic cord with a review of 14 cases in the literature. Jpn J Clin Oncol 14/3: 437–443

    Google Scholar 

  28. Uchida K, Oda T, Adachi H et al. (1999) Malignant fibrous histiocytoma of the spermatic cord: a case report. Int J Urol 6/12: 630–632

    Google Scholar 

  29. Weiss SW, Enzinger FM (1978) Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer 41/6: 2250–2266

    Google Scholar 

  30. Williamson JC, Johnson JD, Lamm DL, Tio F (1980) Malignant fibrous histiocytoma of the spermatic cord. J Urol 123/5: 785–788

    Google Scholar 

  31. Zagars GK, Ballo MT, Pisters PW et al. (2003) Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy: an analysis of 1225 patients. Cancer 97/10: 2530–2543

    Google Scholar 

  32. Zagars GK, Ballo MT (2003) Significance of dose in postoperative radiotherapy for soft tissue sarcoma. Int J Radiat Oncol Biol Phys 56/2: 473–581

    Google Scholar 

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Authors and Affiliations

  1. Chirurgische Klinik des Carl-Thiem-Klinikums Cottbus

    M. May, F. Marusch, C. Helke, I. Gastinger & B. Hoschke

  2. Pathologisches Institut des Carl-Thiem-Klinikums Cottbus

    S. Gunia

  3. Urologische Klinik, Carl-Thiem-Klinikum Cottbus, Lehrkrankenhaus der Universitätsklinik Charité zu Berlin, Thiemstrasse 111, 03048, Cottbus

    M. May

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  1. M. May
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May, M., Marusch, F., Helke, C. et al. Das lokal rezidivierende maligne fibröse Histiozytom der Niere oder des Samenstrangs. Urologe [A] 43, 976–981 (2004). https://doi.org/10.1007/s00120-004-0613-7

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