A CASE OF MALIGNANT FIBROUS HISTIOCYTOMA OF THE ILEUM

Abstract

A 45-year-old woman was seen at the hospital because of headache, palpitation, and general fatigue, and underwent close examination for detected severe anemia. Abdominal ultrasonography, CT scan, and magnetic resonance imaging revealed a solid tumor about 7cm in diameter adjacent to ventral of the uterus. Fluoroscopic study of the small intestine revealed no prominent stenosis nor tumor shadow. At laparotomy, an extraluminally growing fist-sized tumor in the ileum 70cm distal from the terminal ileum was found. The ileum was excised. Histopathologically the tumor was composed of dense proliferation of spindle cells and storiform pattern was obviously seen. Malignant fibrous histiocytoma of usual type was diagnosed. There have been no signs of recurrence and the patient is doing well as of 3.5 years after the operation.
Malignant fibrous histiocytoma of the small intestine is a very rare entity and 14 cases have been reported in Japan. It commonly occurs in middle to elderly men, and often presents with intestinal obstruction and hemorrhage. So we have difficulty in preoperative diagnosis. Although the patients manifesting peritoneal dissemination and hematogenic metastasis have a poor prognosis, long-term survival can be expected for the patients having lymph nodes metastasis and invasion into the surrounding organs by radical operation.