Transanal excision of a malignant fibrous histiocytoma of anal canal: a case report and literature review.
Malignant fibrous histiocytoma, which is composed of spindle-shaped cells arranged in a pleomorphic and storiform pattern, is rarely found in the colorectum. Although complete surgical excision remains the main stem of therapy, an optimal treatment strategy according to the stage has not been elucidated. We report a case of a 63-year-old woman with an ulcerative lesion in the anorectal junction and a final diagnosis of malignant fibrous histiocytoma. We introduced an access for transanal local excision and adjuvant radiotherapy because the patient refused abdominoperineal resection. No local recurrences or distant metastases were observed 15 mo after the operation. To our knowledge, this is the first case reported in the English literature of a malignant fibrous histiocytoma treated with the transanal local excision and adjuvant radiotherapy. This report showed that this approach is selectively reserved for early-stage malignant fibrous histiocytoma and for those patients who refuse radical surgery because of the risk in a permanent colostomy.
Kim
Beom Gyu
BG
Department of Surgery, Chung-Ang University College of Medicine, Chung-Ang University, 224-1 Heukseok_Dong, Dongjak-Gu, Seoul 156-755, Korea.
Chang
In Taik
IT
Park
Jun Seok
JS
Choi
Yoo Shin
YS
Kim
Gi Hyeon
GH
Park
Eon Sub
ES
Choi
Chang Hwan
CH
D001003:Anal Canal / Q000601:surgery; D001005:Anus Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011351:Proctoscopy / Q000379:methods*; D018714:Radiotherapy, Adjuvant