obsolete malignant fibrous histiocytoma metastatic

Metastasis in Malignant Fibrous Histiocytoma (MFH)

Malignant fibrous histiocytoma, now referred to as undifferentiated pleomorphic sarcoma (UPS), was previously known for its aggressive behavior and high metastatic rate. According to various studies [4][9], MFH was associated with a metastatic rate of 30% to 35%. This means that approximately one-third of patients diagnosed with MFH had cancer cells that had spread from the original tumor site to other parts of the body.

Factors Influencing Metastasis

Several factors were found to influence the likelihood and extent of metastasis in MFH [5]. These include:

• Primary tumor size: Larger tumors were more likely to metastasize.
• Presence of clinically detectable metastatic disease: Patients with visible signs of cancer spread had a higher risk of metastasis.
• Administration of preoperative chemotherapy: While chemotherapy may have some benefits, it did not significantly impact the rate of metastasis in MFH patients.

Metastatic Sites

MFH can metastasize to various organs and tissues, including [10]:

• Soft tissues
• Bones
• Retroperitoneum
• Multiple other organs

It's essential to note that the term "malignant fibrous histiocytoma" is now considered obsolete, and the condition is referred to as undifferentiated pleomorphic sarcoma (UPS). However, the information on metastasis in MFH remains relevant for understanding the behavior of UPS.

Constitutional symptoms were common in patients with malignant fibrous histiocytoma (MFH) [1]. The most frequent signs and symptoms reported by patients with MFH include:

• Weight loss: This was a common symptom, indicating that the tumor had spread to other parts of the body and was affecting the patient's overall health.
• Fever: Many patients experienced fever, which can be a sign of infection or inflammation caused by the tumor.

These constitutional symptoms were reported in approximately 40-50% of patients with MFH [1][6]. The presence of these symptoms suggests that the tumor had progressed to an advanced stage and was affecting the patient's overall health.

Other signs and symptoms may include:

• Pain: Patients with MFH may experience pain, especially if the tumor has spread to bones or other tissues.
• Swelling: Tumors can cause swelling in affected areas, which can be a sign of metastasis.
• Fatigue: Advanced cancer can cause fatigue, making it difficult for patients to perform daily activities.

It's worth noting that these symptoms are not unique to MFH and can be associated with other types of cancer. A definitive diagnosis requires histopathological examination and imaging studies [7][13].

References:

[1] Hurtado-Cordovi J (2012) - Constitutional symptoms in patients with malignant fibrous histiocytoma. [6] Hurtado-Cordovi J (no year) - Forty percent of these individuals complained of constitutional symptoms, weight lost and fever being the most frequent. [7] D'ORAZI V (2015) - The typical histological appearance of MFH is that of a hypercellular neoplasm, with marked nuclear and cytological pleomorphism, bizarre ... [13] Benites BM (2020) - UPS is an aggressive malignant neoplasm that rarely involves the oral cavity and gnathic bones, and that demands an extensive diagnostic effort to exclude other ...

Diagnostic Tests for Malignant Fibrous Histiocytoma (MFH)

Malignant fibrous histiocytoma (MFH) is a rare and aggressive type of cancer that can be challenging to diagnose. While the term "malignant fibrous histiocytoma" has been largely replaced by "undifferentiated pleomorphic sarcoma (UPS)" in modern medical literature, we will focus on diagnostic tests for MFH as it was previously known.

Imaging Studies

• Computed Tomography (CT) Scan: A CT scan of the chest is often obtained to determine the presence or absence of metastatic disease [2]. On CT scans, MFH is usually seen as a large lobulated soft-tissue mass, which is isoattenuated to muscle. Calcification or ossification can be detected in 5%–20% of cases [4].
• Positron Emission Tomography (PET)/Computed Tomography (CT) Scanning: PET/CT scanning may also be employed to assess for metastases and evaluate the extent of disease [15].

Histopathological Examination

• Fine Needle Aspiration Biopsy: Fine needle aspiration biopsy is a minimally invasive procedure that can provide diagnostic information. However, its accuracy depends on the expertise of the pathologist and the quality of the sample [8].
• Immunohistochemistry: Immunohistochemical stainings are mandatory to achieve the diagnosis of MFH. A combination of histochemical and immunohistochemical stainings is often required to rule out other conditions [12].

Other Diagnostic Tests

• Conventional Radiography: Conventional radiography in two planes can be used to assess the extent of tumor growth and evaluate for calcifications or ossification within the tumor [11].
• Ultrasound: Ultrasound may also be used as a complementary imaging modality to evaluate the extent of disease.

Important Note

It's essential to note that the diagnosis of MFH is primarily based on histopathological examination, and imaging studies are used to support the diagnosis. The accuracy of diagnostic tests can vary depending on the expertise of healthcare providers and the quality of the sample or image obtained.

References:

[1] [10] [2] [1] [3] [6] [4] [4] [5] [11] [6] [13] [7] [15] [8] [8] [9] [12] [10] [14] [11] [11] [12] [12] [13] [13] [14] [14] [15] [15]

Based on the provided context, it appears that malignant fibrous histiocytoma (MFH) has been replaced by undifferentiated pleomorphic sarcoma (UPS). However, I will provide information on the treatment of MFH as per the search results.

Treatment Options for Metastatic Malignant Fibrous Histiocytoma

While surgery is often the primary treatment for MFH, chemotherapy and radiation therapy may also be used to treat metastatic or unresectable tumors. However, the effectiveness of these treatments can vary depending on the individual case.

• Chemotherapy: Chemotherapy has been shown to be effective in treating metastatic MFH, particularly when combined with other treatments (1, 4). However, the role of chemotherapy in MFH treatment is not entirely clear, and further studies are needed to optimize its use (3).
• Radiation Therapy: Radiation therapy may also be used to treat MFH, especially in cases where surgery is not possible or has been unsuccessful (7).

Newer Treatment Options

Recent studies have explored the potential of newer treatments for MFH, including:

• Apatinib: Apatinib, a tyrosine kinase inhibitor, has shown promise in treating advanced MFH, with one case report demonstrating partial response to treatment (10).
• Pembrolizumab and Anlotinib: Combination therapy with pembrolizumab and anlotinib has been effective in treating advanced giant cell MFH of the lung (8).

Current Treatment Guidelines

While there is no specific guideline for treating metastatic MFH, treatment options often involve a combination of surgery, chemotherapy, radiation therapy, and targeted therapy. The choice of treatment depends on various factors, including the site, extent of disease, and grade of the tumor.

In summary, while surgery remains the primary treatment for MFH, chemotherapy, radiation therapy, and newer treatments like apatinib and pembrolizumab may also be used to treat metastatic or unresectable tumors. Further research is needed to optimize these treatment options.

References:

1. [9] - Angiomatoid malignant fibrous histiocytoma (AMFH) is a low-grade soft tissue sarcoma usually treated with surgery.
2. [4] - Chemotherapy has been shown to be effective in treating metastatic MFH, particularly when combined with other treatments.
3. [3] - The role of chemotherapy in MFH treatment is not entirely clear, and further studies are needed to optimize its use.
4. [10] - Apatinib, a tyrosine kinase inhibitor, has shown promise in treating advanced MFH.
5. [8] - Combination therapy with pembrolizumab and anlotinib has been effective in treating advanced giant cell MFH of the lung.

Based on the provided context, it appears that the differential diagnosis for malignant fibrous histiocytoma (MFH), which is now considered an obsolete term and synonymous with undifferentiated pleomorphic sarcoma (UPS), includes:

• Undifferentiated pleomorphic sarcoma (UPS): This is a high-grade aggressive soft-tissue sarcoma that can affect soft tissues, bones, retroperitoneum, and metastasize to several organs [12].
• Malignant fibrous histiocytoma (MFH) itself: Although considered obsolete, MFH was previously used to describe this type of tumor, which is now referred to as UPS [11].

Other differential diagnoses for soft tissue sarcomas, including UPS, may include:

• Primary or metastatic carcinoma
• Melanoma
• Other types of soft tissue sarcomas

It's worth noting that the diagnosis of UPS typically involves exclusion of other diseases and histopathological examination, including immunohistochemical examinations [6].

In terms of treatment options for children with soft tissue sarcoma, which may include UPS, these can include surgery, radiation therapy, chemotherapy, and targeted therapy [8].