Myxoid malignant fibrous histiocytoma of the bladder

✍ Scribed by Joseph E. Oesterling; Jonathan I. Epstein; Charles B. Brendler

• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 943 KB
• Volume: 66
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19901015)66:8<1836::aid-cncr2820660832>3.0.co;2-y

✦ Synopsis

Although the most common soft tissue sarcoma of adulthood, malignant fibrous histiocytoma (MFH) is an extremely rare tumor of the urinary bladder. Only three well-documented cases have been reported in the world literature. The patient presented in this report represents the first case of the myxoid variant to develop in the urinary bladder. Whereas all previous patients with MFH of the bladder had intermittent hematuria, this patient's chief complaint was bladder outlet obstruction due to extension of the tumor into the prostate. He was managed with radical cystoprostatectomy, postoperative radiation therapy to the tumor bed, and adjuvant chemotherapy using doxorubicin. The patient tolerated the therapy well and was disease-free at the %year follow-up visit. The histogenesis, clinical features, pathologic characteristics, and treatment considerations of this rare bladder tumor are discussed in detail. Cancer 66:1836-1842,1990. ALIGNANT FIBROUS HISTIOCYTOMA (MFH), ah0 M referred to in the past as malignant fibrous xanthoma' and fibroxanthosarcoma,' is a tumor of mesenchymal tissue origin. Originally described as a separate entity in 1963 by Ozzella and associate^,^ and in 1964 b y

O'Brien and Stout,' this neoplasm is a pleomorphic sarcoma that contains two cell types: fibroblast-like cells and histiocyte-like cells. Because each tumor contains varying proportions of these two cell types, a wide range of histologic appearances is possible. As a result, malignant fibrous histiocytomas have been characterized into five major subtypes: storiform-pleomorphic, myxoid, giant cell, inflammatory, and a n g i ~m a t o i d . ~. ~ Of these, the storiform-pleomorphic variant is the most common, whereas the myxoid subtype is the slowest growing.6

Malignant fibrous histiocytoma is the most common adult soft tissue sarcoma, comprising 10% to 21% of all such turn or^.^^' Most lesions present late in life during the sixth and seventh decade^.^ MFH in childhood is very