A SURGICAL CASE OF GIANT RETROPERITONEAL MALIGNANT FIBROUS HISTIOCYTOMA THAT RECURRED EIGHT YEARS POSTOPERATIVELY

Abstract

Malignant fibrous histiocytoma (MFH) reportedly occurs in the abdomen or retroperitoneum in about 10% of cases. We have successfully resected a giant MFH that recurred eight years postoperatively. We report this case with a brief review of the literature. The patient an 87-year-old male, visited our hospital with a chief complaint of left hypochondralgia. On physical examination, an enormous mass was palpated in the left hypochondrium and lower abdomen. His past history was remakable in that he had undergone MFH resection eight years before at our hospital and detailed records were thus available. CT and MRI showed a mass measuring about 20cm in the left abdomen. Barium enema suggested extracolonic pressure on the displaced sigmoid and transverse colons. Angiography showed a hypovascular mass. From these findings, we diagnosed the tumor as a recurrent MFH. The tumor was resected with left hemicolectomy and splenectomy. Pathological diagnosis was storiform-pleomorphic type MFH. Giant retroperitoneal MFH is reportedly associated with frequent local recurrence and metastasis. The prognosis is very poor. Since there is no apparent agreement on the efficacy of chemotherapy or radiotherapy, surgical intervention would be the first choice. We found no previous reports of a giant retroperitoneal MFH re-resected many years postoperatively.