title: Tandem high-dose chemotherapy supported by autologous peripheral blood stem-cell transplantation and radiotherapy for recurrent malignant fibrous histiocytoma.
abstract: Malignant fibrous histiocytoma (MFH) is a soft-tissue sarcoma created from fibroblast cells and characterized by a high rate of metastasis or recurrence with poor prognosis. We report a case of initially well differentiated (G1) MFH of the trunk in a 33-year-old woman. Two years after primary diagnosis, metastases were found in the lung, trunk, gluteus region, upper extremities and brain. Histopathological findings indicated a stromal tumor consisting of spindle cells, and immunohistochemical examination of resected specimens established the definite diagnosis of poorly differentiated MFH (G3). Initial surgery of several solid tumors on the trunk, lung and extremities was performed. There was a high local recurrence and metastasis rate, and the patient was treated with radiotherapy and conventional chemotherapy followed by tandem high-dose chemotherapy and peripheral blood stem-cell transplantation. She is currently well seven years after the transplant, with no signs of metastasis and recurrence. We review the clinical picture of the tumor in this patient and discuss its diagnosis, pathogenesis and treatment.
authors.affiliation: Department of Radiation and Radio-Oncology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany. eboelke@aol.com
authors.forename: Edwin
authors.initials: E
authors.lastname: Bölke
authors.forename: Leilani
authors.initials: L
authors.lastname: Ruf
authors.forename: Wilfried
authors.initials: W
authors.lastname: Budach
authors.forename: Petra
authors.initials: P
authors.lastname: Reinecke
authors.forename: Ansgar
authors.initials: A
authors.lastname: Röhrborn
authors.forename: Hildegard
authors.initials: H
authors.lastname: Pape
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarz
authors.forename: Gerd
authors.initials: G
authors.lastname: Schmitt
authors.forename: Carlo
authors.initials: C
authors.lastname: Aul
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D051677:Histiocytoma, Malignant Fibrous / Q000628:therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D011878:Radiotherapy; D012983:Soft Tissue Neoplasms / Q000601:surgery / Q000628:therapy*; D013903:Thoracic Surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D004317:Doxorubicin; D007069:Ifosfamide