Combined Surgery, Chemotherapy and Radiotherapy of Primary Pulmonary Malignant Fibrous Histiocytoma: A Case Report

Xiaobing Feng,Yuhai Zhang,Yuemin Li,Lele Song,Shaolin Meng,Xiaojing Wang

doi:10.21767/2576-3903.100007

Abstract

Primary pulmonary soft tissue sarcomas are a type of rare malignant tumor that could be misdiagnosed as intimal pulmonary carcinomas or metastasis of other carcinomas. Malignant fibrous histiocytoma (MFH) is one type of the soft tissue sarcoma. The MFH is often seen in deep soft tissue of the extremities, trunk and peritoneum, while primary MFH in lung is rarely seen. Here we report a case of a 46-year-old woman who first presented shoulder pain and a mass lesion occupying almost 1/2 of the left hemi thorax. A malignant pulmonary tumor was considered, and an exploratory thoracotomy was performed. Due to severe adhesion with pulmonary artery, the tumor was not completely removed. Subsequent pathological examination identified the lesion as primary pulmonary malignant fibrous histiocytoma. Combined chemo- and radiotherapy were performed after exploratory surgery and exhibited good therapeutic effects. The patient is on regular follow-up for six years and is currently recovering well with no evidence of relapse. The aim of this case report is to share our experience in treating rare primary pulmonary MFH with combined surgery, chemo- and radiotherapy.

Highlights

The World Health Organization (WHO) Consensus Committee defined pulmonary sarcomatoid carcinoma as a group of poorly differentiated non–small cell lung carcinomas that contain a component of sarcoma or sarcoma-like differentiation [1]
The report from Salter et al [2] suggested that the primary pulmonary sarcomas were uncommon, in which Malignant fibrous histiocytoma (MFH) accounts for less than 5% of adult sarcomas
We treated a 46-yearold female of primary pulmonary malignant fibrous histiocytoma with surgery and combined chemo radiotherapy, and she has survived without relapse for 6 years

Summary

Introduction

The World Health Organization (WHO) Consensus Committee defined pulmonary sarcomatoid carcinoma as a group of poorly differentiated non–small cell lung carcinomas that contain a component of sarcoma or sarcoma-like (spindle or giant cell or both) differentiation [1]. The patient first presented shoulder pain with a huge mass lesion detected by the chest X-ray in the left inferior lung field in another hospital. The report from Salter et al [2] suggested that the primary pulmonary sarcomas were uncommon, in which MFH accounts for less than 5% of adult sarcomas. MFH often occurs to lower limbs while rarely occurs in the lung.

Results

Conclusion