Oncological and Functional Outcome of Malignant Fibrous Histocytoma of Bone (MFH) of Upper and Lower Extremities Treated by Limb Salvage and Chemotherapy
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- Category: Vol. 78, December 2010
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Oncological and Functional Outcome of Malignant Fibrous Histocytoma of Bone (MFH) of Upper and Lower Extremities Treated by Limb Salvage and Chemotherapy,AMR M.S. ABD EL-MEGUID and WALID A. EBEID
Abstract
Introduction: Malignant fibrous histocytoma (MFH), a type of sarcoma, is a malignant neoplasm of uncertain origin that arises both in soft tissue and bone [1]. It was first described by O'Brien and Stout in 1964, as the most common tissue sarcoma in late adult life [1]. Malignant fibrous histocytoma is a tumor rich in histocytes with storiform growth pattern.
Aim of Work: To asses the Oncological and Functional Outcome of Malignant Fibrous Histocytoma of Bone (MFH) Treated By Limb Salvage and Chemotherapy.
Material and Methods: This prospective random study was carried on 24 patients (16 males and 8 females), with age range from 8 to 62 years old, complaining from Malignant Fibrous Histocytoma of the upper and lower extremities. All cases were treated at Cairo University Hospitals from 1997 to 2007. All patients underwent wide surgical resection of the lesion and limb salvage using different modalities of fixations. Post-operative they also received different chemotherapy regimens depending on the time of entry to the study with a minimum follow-up period of 2 years. Patient functional outcome was evaluated according to the Musculoskeletal Tumor Society Functional Rating System (MSTS).
Results: After a minimum follow-up period of 2 years, functional outcome of the patients were satisfactory. Four patients suffered an isolated local recurrence, 3 had a local recurrence simultaneously with pulmonary chest metastases, and 7 patients had distant pulmonary metastases without local recurrence. Sciatic nerve lesion was observed in 1 case, 3 cases developed late postoperative infection. Among these 24 patients, 8 patient have die from chest metastases. Six patients were not available one year after surgery, and the remaining 18 patients, their functional score ranged from 20 to 30, (average score was 25).
Conclusion: We concluded that, proper surgical technique together with good chemotherapy regimens make limb salvage possible for patients with malignant fibrous histocytoma of the upper and lower extremities. This procedure yields a good oncologic outcome.