• Archives of Plastic Surgery
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• 제35권4호
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• pp.439-445
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• 2008

Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.

• Journal of Chest Surgery
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• 제33권4호
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• pp.333-337
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• 2000

Malignant fibrous histiocytoma(MFH) is a deep-seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. However, it only rarely occurs in the chest wall. An 85-year-old man had undeergone excision of a small mass on the right posterior chest wall under local anesthesia 14 months age. However, the lesion did not heal and the mass recurred. He was referred to our hospital after the mass had grown to a size of 10.5$\times$8$\times$4cm with a 3$\times$3cm skin defect. Intraoperative frozen biopsy revealed MFH. An en-bloc wide resection and thin-thickness skin graft from his thigh were performed. Although distant metastasis to the lund developed 14 months later and the patient died 2 months later, there was no local recurrence. Thin-thickness skin graft is a simple method for a wide range skin defect, especially in the old age. He recovered in good condition without any physical disabilities.

• 대한영상의학회지
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• 제85권3호
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• pp.654-660
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• 2024

원발성 악성 섬유성 조직구종은 요로, 특히 방광에서 흔하게 발생하지 않는 중간엽 유래의 악성 종양이다. 방광암의 대부분을 차지하는 요로 상피암과는 달리, 악성 섬유성 조직구종은 점막 고유층, 고유근층, 장막층으로 구성된 방광 벽의 요로 상피 하부에서 발생한다. 조직학적 기원은 섬유아세포와 조직구 세포가 부분적으로 분화된 저분화 중간엽 줄기세포에서 발생하는 것으로 추정된다. 영상의학적으로는 요로 상피암에서 흔히 볼 수 있는 유두상 성장 패턴을 보이지 않아 '비유두상 종양'으로 알려져 있으며, 흔히 고유근층 이상의 침범을 보이고 괴사를 동반하지 않는 거대 종괴의 형태로 진단된다. 이 드문 악성 종양의 예후는 다양한 병리학적 인자에 의해 결정되지만, 일반적으로 불량한 예후와 높은 국소 재발률을 보인다. 또한 무통성 혈뇨를 주로 호소하는 요로 상피암 환자와 달리 주변 장기를 압박하여 비특이적인 하복부 통증이 나타날 수 있어 진단에 어려움이 있을 수 있다. 저자들은 혈뇨 없이 하복부 통증을 주 증상으로 내원하여 방광의 원발성 악성 섬유성 조직구종으로 진단된 후 빠른 치료를 시작하였음에도 매우 공격적인 임상 경과를 보였던 증례를 보고하고자 한다.