Journal of Gastrointestinal Cancer

, Volume 41, Issue 4, pp 238–242 | Cite as

Primary Intra-abdominal Malignant Fibrous Histiocytoma: A Highly Aggressive Tumor

  • Nikolaos S. SalemisEmail author
  • Stavros Gourgiotis
  • Evangelos Tsiambas
  • Nikolaos Panagiotopoulos
  • Andreas Karameris
  • Efstathios Tsohataridis
Original Research


Background and Purpose

Malignant fibrous histiocytoma (MFH) is the most common soft-tissue sarcoma of late adult life occurring predominantly in the extremities. Primary intra-abdominal MFH is a very rare occurrence. The aim of this study is to describe a very rare case of an intra-abdominal MFH with a highly aggressive clinical course.


A 67-year-old male was referred to our department with a 2-week history of dull lower abdominal pain and a gradually enlarging right lower abdominal mass, which he first noticed 2 months prior to admission. Computed tomography (CT) scan demonstrated a mass in the right iliac fossa.


On exploratory laparotomy, a tumor was found in the right iliac fossa attached to the parietal lateral peritoneum without any evidence of invasion into the adjacent structures. Complete excision of the tumor with clear margins was performed. Histological and immunohistochemical examinations showed a MFH. One month after surgery, while on adjuvant chemotherapy, the patient was readmitted with dyspnea and a slightly palpable mass in the area of the previous radical resection. CT scan revealed local tumor recurrence along with multiple pulmonary metastatic deposits. Unfortunately, despite treatment, the patient died of progressive disease 5 weeks later.


Primary intra-abdominal MFH is a very rare but aggressive malignancy with a high tendency of local recurrence and metastatic spread. Early detection and complete surgical excision with clear margins is the treatment of choice. In some cases, however, the tumor can exhibit a highly aggressive clinical course despite radical surgery and adjuvant therapy.


malignant fibrous histiocytoma abdominal aggressive tumor 



Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Weiss SW, Enzinger FM. Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer. 1978;41:2250–66.CrossRefPubMedGoogle Scholar
  2. 2.
    Bruneton JN, Drouillard J, Rogopoulos A, Laurent F, Normand F, Balu-Maestro C, et al. Extraretroperitoneal abdominal malignant fibrous histiocytoma. Gastrointest Radiol. 1988;13:299–305.CrossRefPubMedGoogle Scholar
  3. 3.
    Rööser B, Willén H, Gustafson P, Alvegård TA, Rydholm A. Malignant fibrous histiocytoma of soft tissue. A population-based epidemiologic and prognostic study of 137 patients. Cancer. 1991;67:499–505.CrossRefPubMedGoogle Scholar
  4. 4.
    Belal A, Kandil A, Allam A, Khafaga Y, El-Husseiny G, El-Enbaby A, et al. Malignant fibrous histiocytoma: a retrospective study of 109 cases. Am J Clin Oncol. 2002;25:16–22.CrossRefPubMedGoogle Scholar
  5. 5.
    Pezzi CM, Rawlings Jr MS, Esgro JJ, Pollock RE, Romsdahl MM. Prognostic factors in 227 patients with malignant fibrous histiocytoma. Cancer. 1992;69:2098–103.CrossRefPubMedGoogle Scholar
  6. 6.
    Heck RK. Soft-tissue tumors. In: Canale ST, Beaty JH, editors. Campbell’s operative orthopaedics. 11th ed. Philadelphia: Mosby Elsevier; 2008. p. 939–60.Google Scholar
  7. 7.
    Qureshi NA, Hallissey MT, Fielding JW, Gourevitch D. Primary intra-abdominal malignant fibrous histiocytoma presenting as pyrexia of unknown origin report of a case with review of literature. Int Semin Surg Oncol. 2006;3:15.CrossRefPubMedGoogle Scholar
  8. 8.
    O'Brien JE, Stout AP. Malignant fibrous xanthomas. Cancer. 1964;17:1445–55.CrossRefPubMedGoogle Scholar
  9. 9.
    Atmatzidis KS, Pavlidis TE, Galanis IN, Papaziogas BT, Papaziogas TB. Malignant fibrous histiocytoma of the abdominal cavity: report of a case. Surg Today. 2003;33:794–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Kotan C, Kosem M, Alici S, Ilhan M, Tuncer I, Harman M. Primary malignant fibrous histiocytoma of the small intestine presenting as an intussusception: report of a case. Surg Today. 2002;32:1091–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Chen HC, Chen CJ, Jeng CM, Yang CM. Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture. World J Gastroenterol. 2007;13:6441–3.CrossRefPubMedGoogle Scholar
  12. 12.
    Ko SF, Wan YL, Lee TY, Ng SH, Lin JW, Chen WJ. CT features of calcifications in abdominal malignant fibrous histiocytoma. Clin Imaging. 1998;22:408–13.CrossRefPubMedGoogle Scholar
  13. 13.
    Farinon AM, Bock E, Federico F, Rulli F, D'Antini P. Primary malignant fibrous histiocytoma of the duodenum. Dig Surg. 1999;16:425–30.CrossRefPubMedGoogle Scholar
  14. 14.
    Wang ZS, Xiong CL, Zhan N, Xiong GS, Li H, Hu H. Primary malignant fibrous histiocytoma of the small bowel: a report of an additional case in duodenum. Int J Gastrointest Cancer. 2005;36:105–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Fu DL, Yang F, Maskay A, Long J, Jin C, Yu XJ, et al. Primary intestinal malignant fibrous histiocytoma: two case reports. World J Gastroenterol. 2007;13:1299–302.PubMedGoogle Scholar
  16. 16.
    Matsumoto S, Ahmed AR, Kawaguchi N, Manabe J, Matsushita Y. Results of surgery for malignant fibrous histiocytomas of soft tissue. Int J Clin Oncol. 2003;8:104–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Zagars GK, Mullen JR, Pollack A. Malignant fibrous histiocytoma: outcome and prognostic factors following conservation surgery and radiotherapy. Int J Radiat Oncol Biol Phys. 1996;34:983–94.PubMedGoogle Scholar
  18. 18.
    No authors listed. Adjuvant chemotherapy for localized resectable soft tissue sarcoma of adults: meta-analysis of individual data. Sarcoma Meta-analysis Collaboration. Lancet. 1997;350:1647–54.CrossRefGoogle Scholar
  19. 19.
    Liesveld JL, Rush S, Kempski MC, Turner AR, Brennan JK, Gasson JC, et al. Phenotypic characterization of the human fibrous histiocytoma giant cell tumor (GCT) cell line and its cytokine repertoire. Exp Hematol. 1993;21:1342–52.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Nikolaos S. Salemis
    • 1
    • 3
    Email author
  • Stavros Gourgiotis
    • 1
  • Evangelos Tsiambas
    • 2
  • Nikolaos Panagiotopoulos
    • 1
  • Andreas Karameris
    • 2
  • Efstathios Tsohataridis
    • 3
  1. 1.2nd Department of SurgeryArmy General HospitalAthensGreece
  2. 2.Department of PathologyArmy Veterans General HospitalAthensGreece
  3. 3.2nd Department of SurgeryArmy Veterans General HospitalAthensGreece

Personalised recommendations