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1/23. Spontaneous epidural haematoma associated with radiation-induced malignant fibrous histiocytoma.

    We report a case of spontaneous epidural haemorrhage associated with metastatic radiation-induced malignant fibrous histiocytoma of the dural meninges in a patient who had been previously treated for nasopharyngeal carcinoma with radiotherapy.
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ranking = 1
keywords = radiation-induced
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2/23. A case of malignant fibrous histiocytoma after breast conserving therapy for breast cancer.

    A 45-year-old woman with malignant fibrous histiocytoma (MFH) of the breast following breast conserving therapy (BCT) is described. She noticed a lump in her left breast 52 months after BCT for breast cancer. The lump was excised and nodular fasciitis was initially diagnosed. However, the tumor recurred locally 4 times in the next 18 months. MFH was finally diagnosed. This case is considered to be radiation-induced sarcoma. The risk of radiation-induced sarcoma after BCT seems to be very low, however careful follow-up is necessary.
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ranking = 0.4
keywords = radiation-induced
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3/23. Genetic characterization of angiomatoid fibrous histiocytoma identifies fusion of the FUS and ATF-1 genes induced by a chromosomal translocation involving bands 12q13 and 16p11.

    This case report documents the first karyotypic, fluorescence in situ hybridization, and genetic analysis of an angiomatoid fibrous histiocytoma that arose and recurred in the arm of a 5.5-year-old girl. Complex rearrangements between chromosomes 2, 12, 16, and 17 were noted, as well as deletion in the long arm of chromosome 11. flow cytometry revealed a normal cell population. The t(12;16) site was further investigated using reverse transcriptase-polymerase chain reaction. We found that the FUS (also known as TLS) gene from 16p11 combined with the ATF-1 gene from 12q13 to generate a chimeric FUS/ATF-1. The FUS gene is rearranged in the t(12;16)(q13;p11) that characterizes myxoid liposarcoma and in acute myeloid leukemia with t(16;21)(p11;q22), while the ATF-1 gene is rearranged in the t(12;22)(q13;q12) found recurrently in clear cell sarcomas (malignant melanoma of soft parts). Thus, the FUS/ATF-1 gene in angiomatoid fibrous histiocytoma is predicted to code for a protein that is very similar to the chimeric EWS/ATF-1 found in clear cell sarcoma.
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ranking = 0.00025378574488606
keywords = leukemia
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4/23. Squamous cell carcinoma detected by high-molecular-weight cytokeratin immunostaining mimicking atypical fibroxanthoma.

    Atypical fibroxanthoma can mimic other tumors, particularly spindle cell squamous cell carcinoma and spindle cell or desmoplastic melanoma. We describe a patient with chronic lymphocytic leukemia who developed acantholytic squamous cell carcinoma on the face, which recurred and metastasized to a cervical lymph node. This tumor was at first diagnosed as atypical fibroxanthoma because of its histologic and immunostaining similarity. It showed weak or negative keratin cocktail staining and strong vimentin staining. However, a recurrent tumor was immunostained for high-molecular-weight keratin and showed strong positivity. Aggressive behavior of this squamous cell carcinoma may be due to altered immune response secondary to chronic lymphocytic leukemia.
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ranking = 0.00050757148977212
keywords = leukemia
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5/23. Early radiation-induced malignant fibrous histiocytoma of the oral cavity.

    With an incidence of less than 0.3 per cent, post-radiation sarcomas are rare malignant neoplasms with a very poor prognosis. On average, they occur after a latency period of at least 15 years following radiation therapy with doses ranging from 24 to 80 Gy. We present the case of a post-irradiation malignant fibrous histiocytoma (MFH) on the floor of the mouth in a 79-year-old male patient arising only five and a half years after radiation therapy. The primary tumour was classified as a well differentiated squamous cell carcinoma of the right rim of the tongue. Primary therapy was surgical resection of the tumour and post-operative radiation with 50 Gy. Five and a half years later, the patient developed a rapidly progressing MFH within the field of radiation.
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ranking = 0.8
keywords = radiation-induced
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6/23. Development of chronic myelocytic leukemia after chemotherapy for malignant fibrous histiocytoma.

    At the age of 28, a 33-year-old male was diagnosed with malignant fibrous histiocytoma (MFH) with a primary lesion in the right maxillary sinus. Although arterial infusion chemotherapy (pirarubicin hydrochloride and carboplatin) was given, no tumor shrinkage was observed, and surgery was therefore performed to remove the tumor. Thereafter, the patient received autologous peripheral blood stem cell transplantation with high-dose chemotherapy (combination of ifosphamide, carboplatin and etoposide) as pretreatment. An increase in the peripheral leukocyte count was noted 56 months after the diagnosis of MFH was made. Cytogenetic study showed translocation (9;22)(q34;q11). Chronic myelocytic leukemia (CML) was therefore diagnosed. MFH was in a state of complete remission. The clinical course of this patient strongly suggests that this was a case of treatment-related CML that developed after chemotherapy for MFH. Treatment-related malignant blood diseases are known to include acute myelocytic leukemia and myelodysplastic syndrome, but reports of treatment-related CML are rare, although there have been some cases of treatment-related CML occurring several years after pretreatment.
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ranking = 0.0015227144693164
keywords = leukemia
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7/23. Nasopharyngeal angiofibroma.

    Based on this patient's history and the imaging studies, all the consultants agree that they are dealing with a juvenile nasopharyngeal angiofibroma. They agree that a biopsy is not necessary. However, angiography would be obtained by 2 physicians (Drs. Seid and Weber). When treating an extensive JNA, the consultants differ in their approaches. One favors a lateral infratemporal fossa approach (Dr. Gantz), but the others favor a combined approach (Drs. Seid and Weber). In this particular case, 2 experts favor resection (Drs. Gantz and Weber), but one would irradiate (Dr. Seid). There is also disagreement regarding the severity of morbidity. Minor problems include conductive hearing loss, paresis of the third division of the fifth cranial nerve (Dr. Gantz), and a transient facial nerve paralysis (Dr. Weber). They are more concerned about the long-range problems from skull-base radiotherapy including brain-stem compromise, pituitary dysfunction, and radiation-induced malignancies. No one suggests chemotherapy or multimodal therapy. Regarding the natural history of JNA, the views range from no spontaneous regression (Dr. Gantz), gradual involution over time (Dr. Seid), or an indolent nature that requires tapering the treatment to the benign nature of the process (Dr. Weber).
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ranking = 0.2
keywords = radiation-induced
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8/23. Malignant fibrous histiocytoma of the head and neck after radiation for squamous cell carcinoma.

    A 60-year-old man presented with malignant fibrous histiocytoma of the oropharynx. The mass extended into the nasopharynx and larynx and caused severe upper airway obstruction that required emergency tracheotomy. Ten years earlier, he had undergone a right partial glossectomy and segmental mandibulectomy for squamous cell carcinoma of the right tongue base,followed by 50 Gy of radiation delivered over 33 sessions. The tumor was so aggressive that changes in its volume were visually distinguishable during physical examination over a 2-week hospital stay. Histologic evaluation revealed 7 mitotic figures per high-power field. Although radiation-induced malignant fibrous histiocytoma is rare in the head and neck, the recent medical literature indicates that its incidence is rising. This rise has been attributed to the increased effectiveness of head and neck cancer therapy, which results in prolonging patients' survival and, hence, their risk of subsequent disease. Because malignant fibrous histiocytoma is a late complication of radiation therapy, appearing on average 10 years following treatment, it is important that physicians who treat head and neck cancer monitor these patients over the long term and remain alert for its appearance, even despite the apparent "cure" of their original neoplasm.
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ranking = 0.2
keywords = radiation-induced
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9/23. Malignant fibrous histiocytoma of the breast. Report of two cases and review of the literature.

    Sarcomas of the breast are uncommon, accounting for less than 1% of all primary malignancies. Among these tumors, malignant fibrous histiocytoma (MFH) is very rare. Two cases of this neoplasm are reported, with histological findings and surgical treatment. The issue of radiation-induced lesions after surgery for carcinoma and the necessity for a correct preoperative diagnosis is examined. A review of the available literature evaluates the histopathological and biological features of MFH of the breast, for which there are no prospective trials, owing to the rarity of this kind of neoplasm. The extent of surgery or role of axillary lymph nodes dissection and multimodality therapy are discussed.
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ranking = 0.2
keywords = radiation-induced
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10/23. Postradiation malignant fibrous histiocytoma and osteosarcoma of a patient with high telomerase activities.

    BACKGROUND: An extremely rare case of postradiation malignant fibrous histiocytoma (MFH) and osteosarcoma (OS) secondary to radiation therapy for leukemia-related osteolytic lesions is presented. In addition, the telomere biology of these tumors was investigated. CASE REPORT: A 14-year-old boy was diagnosed with acute lymphocytic leukemia. The right tibia was irradiated at a total dose of 60 Gy, and the left tibia was irradiated at a total dose of 40 Gy. The left tibia developed MFH and the right tibia developed OS. RESULTS: telomere reduction (MFH 70.2, OS 70.0%) and high telomerase activities (MFH 12.1, OS 17.7 TPG) were observed. These results reflect an aggressive feature of postradiation sarcomas. CONCLUSION: prognosis for patients diagnosed with postradiation sarcoma is poor due to its aggressiveness. However, even if sarcoma occurs after irradiation in more than two fields in a single patient, improvements in prognosis are anticipated with appropriate chemotherapies and wide resection.
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ranking = 0.00050757148977212
keywords = leukemia
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