title: A case of primary malignant fibrous histiocytoma of the duodenum.
abstract: BACKGROUND
  Primary malignant fibrous histiocytoma (MFH) of the duodenum is rare and a distinct clinical entity.
  
  
  METHODS
  A 55-year-old man presented with a history of upper gastrointestinal bleeding, vomiting and decreased body weight over the past 2 months. Abdominal exam showed an epigastric mass of 10 cm. An upper gastrointestinal endoscopy documented a tumor in the third part of duodenum. The histopathological examination of biopsy has concluded a MFH. Abdominal CT revealed a large and heterogeneous mass of 10 cm in the third part of the duodenum. The intervention was conducted by way of a bi-subcostal laparotomy. Exploration of the tumor revealed involvement of the third part of duodenum. This lesion adhered and invaded the inferior vena cava. A palliative procedure using a gastro-entero-anastomosis was carried out with uneventful postoperative course. Neither adjuvant chemotherapy nor radiotherapy were conducted. The patient died four months following his operation.
  
  
  CONCLUSIONS
  The biological behavior of malignat fibrous histiocytomas is extremely aggressive and mainly conditioned by size and histological grading. The treatment of choice, whenever possible, is based on early and complete surgical excision of the tumor.
authors.affiliation: Department of General Surgery 'A', La Rabta Hospital, Tunis, Tunisia.
authors.forename: Amin
authors.initials: A
authors.lastname: Makni
authors.forename: Faouzi
authors.initials: F
authors.lastname: Chebbi
authors.forename: Haifa
authors.initials: H
authors.lastname: Azzouz
authors.forename: Houcine
authors.initials: H
authors.lastname: Magherbi
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jouini
authors.forename: Montassar
authors.initials: M
authors.lastname: Kacem
authors.forename: Zoubeir Ben
authors.initials: ZB
authors.lastname: Safta
references.citation: South Med J. 1986 Mar;79(3):376-8
references.pmid: 3006265
references.citation: Dig Dis Sci. 2008 Oct;53(10):2808-9
references.pmid: 18322796
references.citation: Arch Pathol Lab Med. 1992 Aug;116(8):872-4
references.pmid: 1323251
references.citation: Dig Surg. 1999;16(5):425-30
references.pmid: 10567806
references.citation: Surgery. 2004 Jan;135(1):59-66
references.pmid: 14694301
references.citation: Clin Radiol. 1998 Sep;53(9):699-701
references.pmid: 9766725
references.citation: Gan To Kagaku Ryoho. 1993 Oct;20(13):2053-6
references.pmid: 8215481
references.citation: Cancer. 1977 Nov;40(5):2010-4
references.pmid: 200332
references.citation: Cancer. 1978 Jun;41(6):2250-66
references.pmid: 207408
references.citation: Dtsch Arztebl Int. 2009 Sep;106(39):632-6
references.pmid: 19890408
references.citation: Cancer. 1976 Jun;37(6):2960-3
references.pmid: 181126
references.citation: Ann Surg Oncol. 1995 Jan;2(1):26-31
references.pmid: 7834450
references.citation: Cancer. 1988 Jan 1;61(1):137-45
references.pmid: 2825958
references.citation: Am J Surg. 1976 Mar;131(3):357-9
references.pmid: 176897
references.citation: J Surg Oncol. 1981;16(2):189-97
references.pmid: 6257982
references.citation: Eur J Obstet Gynecol Reprod Biol. 1998 Sep;80(1):71-3
references.pmid: 9758263
references.citation: AJR Am J Roentgenol. 1995 Jan;164(1):129-34
references.pmid: 7998525
references.citation: Int J Gastrointest Cancer. 2005;36(2):105-12
references.pmid: 16648661
references.citation: Acta Cytol. 1986 Jan-Feb;30(1):48-50
references.pmid: 3004082