MDT discussion of a case of recurrent adult hepatic fibrohistiocytoma with rupture and hemorrhage_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SONG Zimin , XU Feng ,  DAI Chaoliu

Department of Hepatobiliary and Spleen Surgery, Shengjing Hospital Affiliated to China Medical University, Shenyang 110000, P. R. China;

Corresponding author：

DAI Chaoliu, Email: 278170678@qq.com

Keywords：

adult hepatic malignant fibrohistiocytoma; bleeding; recurrent; MDT

DOI：

10.7507/1007-9424.201812080

Video：

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Objective To summarize the experience of diagnosis and treatment of a case of adult hepatic fibrohistiocytoma with recurrent rupture and hemorrhage.Methods Retrospective analysis on this case of recurrent adult fibrohistiocytoma with rupture and hemorrhage admitted to Shengjing Hospital Affiliated to China Medical University in May 2018 was conducted, discussion on MDT was conducted before surgery, and the causes of recurrent rupture and hemorrhage, as well as the experience of diagnosis and treatment were summarized and analyzed.Results This patient was generally in good condition. After MDT discussions among the imaging department, oncology department, interventional department, and hepatobiliary surgeons, it was considered that surgical treatment was the best treatment scheme. After full communication with the patient and his family, the patient had chosen open tumor resection and the operation was smooth. The operation time was 278 min, intraoperative bleeding was about 100 mL, and no blood transfusion was performed. No bleeding, abdominal infection, gastroparesis, and other complications occurred after the operation, and the patient was discharged successfully on the 13^th day after the operation. The patient had been interviewed for 8 months and the tumor recurred again 1 month ago. Currently, oral apatinib had been targeted for treatment for more than 1 month, and the follow-up treatment continued.Conclusions Recurrent adult fibrous histiocytoma with rupture and hemorrhage is rare in clinical practice, and the treatment is mainly based on surgical resection. Postoperative comprehensive treatment combined with radiotherapy, chemotherapy, molecular targeting, and immunotherapy is the main treatment. Its short-term efficacy is satisfactory, but long-term efficacy still needs to befurther observed.

Citation： SONG Zimin, XU Feng, DAI Chaoliu. MDT discussion of a case of recurrent adult hepatic fibrohistiocytoma with rupture and hemorrhage. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 463-468. doi: 10.7507/1007-9424.201812080 Copy

1.	姜喜远, 谢远哲, 王艳华, 等. 肝脏巨大恶性纤维组织细胞瘤伴破裂出血 1 例报告. 吉林医学, 2015, 36(15): 3464-3465.
2.	Sato A, Ishida H, Komatsuda T, et al. Spontaneous ruptured hepatic malignant fibrous histiocytoma. J Med Ultrason (2001), 2006, 33(4): 255-256.
3.	张雪峰, 易大勇, 李孝舜. 肝脏巨大黏液型恶性纤维组织细胞瘤 CT 表现一例. 中华放射学杂志, 2014, 48(12): 1056-1057.
4.	Boxberg M, Steiger K, Lenze U, et al. PD-L1 and PD-1 and characterization of tumor-infiltrating lymphocytes in high grade sarcomas of soft tissue - prognostic implications and rationale for immunotherapy. Oncoimmunology, 2017, 7(3): e1389366.
5.	刘立刚, 何晓东, 李玉民, 等. 胰腺恶性纤维组织细胞瘤的诊治 (附 1 例报道并文献复习). 中国普外基础与临床杂志, 2009, 16(8): 658-660.
6.	O’Brien JE, Stout AP. Malignant fibrous xanthomas. Cancer, 1964, 17: 1445-1455.
7.	Liu Y, Xu B. Primary hepatic malignant fibrous histiocytoma on PET/CT. Clin Nucl Med, 2018, 43(6): e189-e191.
8.	Conran RM, Stocker JT. Malignant fibrous histiocytoma of the liver–a case report. Am J Gastroenterol, 1985, 80(10): 813-815.
9.	Das A, Arya SV, Soni N, et al. A rare presentation of hepatic and splenic cystic malignant fibrous histiocytoma: a case report and literature review. Int J Surg Case Rep, 2013, 4(1): 139-141.
10.	Dong J, An W, Ma W, et al. Primary hepatic malignant fibrous histiocytoma mimicking hepatocellular carcinoma: a report of two cases. Oncol Lett, 2014, 8(5): 2150-2154.
11.	Mass JB, Talmon G. Undifferentiated pleomorphic sarcoma of liver: case report and review of the literature. Case Rep Pathol, 2018, 2018: 8031253.
12.	Tan Y, Xiao EH. Rare hepatic malignant tumors: dynamic CT, MRI, and clinicopathologic features: with analysis of 54 cases and review of the literature. Abdom Imaging, 2013, 38(3): 511-526.
13.	Tong Y, Yu H, Shen B, et al. Primary hepatic malignant fibrous histiocytoma combined with invasion of inferior vena cava: a case report and literature review. Medicine (Baltimore), 2017, 96(23): e7110.
14.	Yao D, Dai C. Clinical characteristics of the primary hepatic malignant fibrous histiocytoma in China: case report and review of the literature. World J Surg Oncol, 2012, 10: 2.
15.	祁佩红, 史大鹏, 郑红伟, 等. 腹部原发性恶性纤维组织细胞瘤的 CT 表现. 实用放射学杂志, 2016, 32(7): 1056-1058, 1062.
16.	祁佩红, 史大鹏, 郑红伟, 等. 肝脏原发性恶性纤维组织细胞瘤的 CT 表现. 中华肝胆外科杂志, 2015, 21(10): 654-657.
17.	金菲, 陈小冬, 吴晓英, 等. 肝纤维肉瘤 1 例报告. 山东医药, 2016, 56(17): 109.
18.	史芳芳, 安维民, 董景辉. 肝脏原发性纤维肉瘤的 MRI 表现与分析. 中国医学装备, 2018, 15(3): 62-65.
19.	刘孟锋, 刘连新. 原发性肝癌自发性破裂出血的诊疗现状. 医学综述, 2017, 23(16): 3193-3196, 3201.
20.	胡章国, 蒋国兴. 乙肝病毒感染与肝癌自发性破裂相关性研究的进展. 中国普外基础与临床杂志, 2013, 20(11): 1325-1328.
21.	Caldeira A, Martin-Carreras F, Pereira E, et al. Malignant fibrous histiocytoma–a rare hepatic tumor. Rev Esp Enferm Dig, 2010, 102(2): 146-147.
22.	Harman M, Nart D, Acar T, et al. Primary mesenchymal liver tumors: radiological spectrum, differential diagnosis, and pathologic correlation. Abdom Imaging, 2015, 40(5): 1316-1330.
23.	Hu JS, Gupta S, Chang SK. Primary hepatic inflammatory malignant fibrous histiocytoma: report of a rare entity and diagnostic pitfall mimicking a liver abscess. Pathology, 2013, 45(4): 430-432.
24.	Dinges S, Budach V, Budach W, et al. Local recurrences of soft tissue sarcomas in adults: a retrospective analysis of prognostic factors in 102 cases after surgery and radiation therapy. Eur J Cancer, 1994, 30A(11): 1636-1642.
25.	Huang H, Cheville JC, Pan Y, et al. PTEN induces chemosensitivity in PTEN-mutated prostate cancer cells by suppression of Bcl-2 expression. J Biol Chem, 2001, 276(42): 38830-38836.

1. 姜喜远, 谢远哲, 王艳华, 等. 肝脏巨大恶性纤维组织细胞瘤伴破裂出血 1 例报告. 吉林医学, 2015, 36(15): 3464-3465.
2. Sato A, Ishida H, Komatsuda T, et al. Spontaneous ruptured hepatic malignant fibrous histiocytoma. J Med Ultrason (2001), 2006, 33(4): 255-256.
3. 张雪峰, 易大勇, 李孝舜. 肝脏巨大黏液型恶性纤维组织细胞瘤 CT 表现一例. 中华放射学杂志, 2014, 48(12): 1056-1057.
4. Boxberg M, Steiger K, Lenze U, et al. PD-L1 and PD-1 and characterization of tumor-infiltrating lymphocytes in high grade sarcomas of soft tissue - prognostic implications and rationale for immunotherapy. Oncoimmunology, 2017, 7(3): e1389366.
5. 刘立刚, 何晓东, 李玉民, 等. 胰腺恶性纤维组织细胞瘤的诊治 (附 1 例报道并文献复习). 中国普外基础与临床杂志, 2009, 16(8): 658-660.
6. O’Brien JE, Stout AP. Malignant fibrous xanthomas. Cancer, 1964, 17: 1445-1455.
7. Liu Y, Xu B. Primary hepatic malignant fibrous histiocytoma on PET/CT. Clin Nucl Med, 2018, 43(6): e189-e191.
8. Conran RM, Stocker JT. Malignant fibrous histiocytoma of the liver–a case report. Am J Gastroenterol, 1985, 80(10): 813-815.
9. Das A, Arya SV, Soni N, et al. A rare presentation of hepatic and splenic cystic malignant fibrous histiocytoma: a case report and literature review. Int J Surg Case Rep, 2013, 4(1): 139-141.
10. Dong J, An W, Ma W, et al. Primary hepatic malignant fibrous histiocytoma mimicking hepatocellular carcinoma: a report of two cases. Oncol Lett, 2014, 8(5): 2150-2154.
11. Mass JB, Talmon G. Undifferentiated pleomorphic sarcoma of liver: case report and review of the literature. Case Rep Pathol, 2018, 2018: 8031253.
12. Tan Y, Xiao EH. Rare hepatic malignant tumors: dynamic CT, MRI, and clinicopathologic features: with analysis of 54 cases and review of the literature. Abdom Imaging, 2013, 38(3): 511-526.
13. Tong Y, Yu H, Shen B, et al. Primary hepatic malignant fibrous histiocytoma combined with invasion of inferior vena cava: a case report and literature review. Medicine (Baltimore), 2017, 96(23): e7110.
14. Yao D, Dai C. Clinical characteristics of the primary hepatic malignant fibrous histiocytoma in China: case report and review of the literature. World J Surg Oncol, 2012, 10: 2.
15. 祁佩红, 史大鹏, 郑红伟, 等. 腹部原发性恶性纤维组织细胞瘤的 CT 表现. 实用放射学杂志, 2016, 32(7): 1056-1058, 1062.
16. 祁佩红, 史大鹏, 郑红伟, 等. 肝脏原发性恶性纤维组织细胞瘤的 CT 表现. 中华肝胆外科杂志, 2015, 21(10): 654-657.
17. 金菲, 陈小冬, 吴晓英, 等. 肝纤维肉瘤 1 例报告. 山东医药, 2016, 56(17): 109.
18. 史芳芳, 安维民, 董景辉. 肝脏原发性纤维肉瘤的 MRI 表现与分析. 中国医学装备, 2018, 15(3): 62-65.
19. 刘孟锋, 刘连新. 原发性肝癌自发性破裂出血的诊疗现状. 医学综述, 2017, 23(16): 3193-3196, 3201.
20. 胡章国, 蒋国兴. 乙肝病毒感染与肝癌自发性破裂相关性研究的进展. 中国普外基础与临床杂志, 2013, 20(11): 1325-1328.
21. Caldeira A, Martin-Carreras F, Pereira E, et al. Malignant fibrous histiocytoma–a rare hepatic tumor. Rev Esp Enferm Dig, 2010, 102(2): 146-147.
22. Harman M, Nart D, Acar T, et al. Primary mesenchymal liver tumors: radiological spectrum, differential diagnosis, and pathologic correlation. Abdom Imaging, 2015, 40(5): 1316-1330.
23. Hu JS, Gupta S, Chang SK. Primary hepatic inflammatory malignant fibrous histiocytoma: report of a rare entity and diagnostic pitfall mimicking a liver abscess. Pathology, 2013, 45(4): 430-432.
24. Dinges S, Budach V, Budach W, et al. Local recurrences of soft tissue sarcomas in adults: a retrospective analysis of prognostic factors in 102 cases after surgery and radiation therapy. Eur J Cancer, 1994, 30A(11): 1636-1642.
25. Huang H, Cheville JC, Pan Y, et al. PTEN induces chemosensitivity in PTEN-mutated prostate cancer cells by suppression of Bcl-2 expression. J Biol Chem, 2001, 276(42): 38830-38836.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MDT discussion of a case of recurrent adult hepatic fibrohistiocytoma with rupture and hemorrhage

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