Year 2011 / Volume 103 / Number 1
Letter to the Editor
Metastatic gastric cancer from malignant fibrous histiocytoma

pp. 44-46

J. A. Contreras Ibáñez, N. Navas García, L. Díaz Gómez

Abstract
We present the case of a 37- years- old male, with no perti- nent pathological history, seen for febrile syndrome and tumor formation on the right thigh. Following a biopsy with a diagno- sis of malignancy, he underwent surgery with radical intent in February 2003 at the Reference Center. The final anatomopat- hological report was pleomorphic Malignant Fibrous Histiocy- toma (MFH) which infiltrated the resection margin.
Following a dissemination study it was staged as T2b diffe- rentiation (stage II)
He was treated with chemotherapy (CT) according to the tre- atment plan of 4-epirubicin plus ifosfamide for 3 cycles before and two cycles after local radiotherapy (RT) with 66 Gy.
In April 2004, the appearance of a 38 °C fever was reported at the same time as a nodule in the right groin region, which un- derwent aspiration puncture with a fine needle (FNA puncture), was suspected of malignancy. On 11-05-2005 the tumor was extirpated and the diagnosis was MFH of 5 cm with no involve- ment of the resection margins.
In March 2006, two pulmonary nodules were identified as having newly appeared; one of 4 cm on the upper left lobe and one of 1.5 cm on the lower left lobe . A thoracic CT scan sho- wed greater involvement with multiple bilateral nodules.He was treated with high doses of ifosfamide and pulmonary RT, with thoracic recovery surgery ruled out.
In July 2007, the progression of bilateral pulmonary lesions and the appearance of lytic metastasis on the fourth dorsal ver- tebra were noted. Chemotherapy was initiated with a docetaxel and gemcitabine treatment plan until January 2008 at which time, due to progression, it was decided that treatment with ET- 743 should be initiated which had to be suspended due to new progression and low functional capacity.
In the evaluation of the response with CT it was proven that not only had the disease advanced but there was also a space- occupying lesion on the stomach. A gastroduodenal study was requested which noted the presence of a large polypoid lesion on the gastric body and antrum. The endoscopy confirmed the lesion and the biopsy diagnosis is: proliferation of spindle cells with marked hyperchomasia and nuclear pleomorphism (IMH). Was positive for vimentine and CD68 and therefore diagnosis of metastatic pleomorphic MFH metastasis was made (Photo1).
In-home symptomatic treatment by the Home Palliative Care Unit was decided upon due to the complete physical dete- rioration and low functional capacity shown.
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J. A. Contreras Ibáñez, N. Navas García, L. Díaz Gómez. Metastatic gastric cancer from malignant fibrous histiocytoma. 44-46


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