Clinical features and prognostic factors of primary intracranial malignant fibrous histiocytoma: A report of 8 cases and a literature review
Peng Li1, Qiangyi Zhou1, Zhijun Yang1, Zhenmin Wang1, Shiwei Li1, Xingchao Wang1, Bo Wang1, Fu Zhao2, Pinan Liu1,2
1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2 Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing 100050, China
Clinical features and prognostic factors of primary intracranial malignant fibrous histiocytoma: A report of 8 cases and a literature review
Peng Li1, Qiangyi Zhou1, Zhijun Yang1, Zhenmin Wang1, Shiwei Li1, Xingchao Wang1, Bo Wang1, Fu Zhao2, Pinan Liu1,2
1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2 Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing 100050, China
摘要 Objective: Primary intracranial malignant fibrous histiocytoma (MFH) is rare. We describe the detailed clinical features of 8 cases and fully review the literature to evaluate several prognostic factors. Methods: Eight patients with pathologically confirmed primary intracranial MFH were retrospectively reviewed. We searched PubMed for relevant articles with the term "intracranial malignant fibrous histiocytoma". Results: Of the 8 patients, 4 were men and 4 were women. Three patients had received previous radiotherapy. The age of the patients ranged from 19 to 69 years, with a median age of 48 years. Most tumors could be totally resected; and only 1 tumor was subtotally resected. Six patients received postoperative radiotherapy and 3 patients received postoperative chemotherapy. Most patients died within the first year after surgery; and only 1 patient was still alive on the date of the last follow-up. We reviewed the literature and included a total of 46 patients in the Kaplan-Meier survival analysis. Young patients (less than 30 years old) seemed to have a better prognosis and survival rate than older patients (more than 30 years old) (log-rank test, P=0.008). However, sex (P=0.675), extent of resection (P=0.934), postoperative radiotherapy (P=0.592), and postoperative chemotherapy (P=0.424) did not affect patient prognosis. Conclusions: The prognosis of MFH is usually poor, and most patients die within the first year after surgery. Younger MFH patients (less than 30 years old) seem to have a better prognosis and improved survival compared to older patients.
Abstract: Objective: Primary intracranial malignant fibrous histiocytoma (MFH) is rare. We describe the detailed clinical features of 8 cases and fully review the literature to evaluate several prognostic factors. Methods: Eight patients with pathologically confirmed primary intracranial MFH were retrospectively reviewed. We searched PubMed for relevant articles with the term "intracranial malignant fibrous histiocytoma". Results: Of the 8 patients, 4 were men and 4 were women. Three patients had received previous radiotherapy. The age of the patients ranged from 19 to 69 years, with a median age of 48 years. Most tumors could be totally resected; and only 1 tumor was subtotally resected. Six patients received postoperative radiotherapy and 3 patients received postoperative chemotherapy. Most patients died within the first year after surgery; and only 1 patient was still alive on the date of the last follow-up. We reviewed the literature and included a total of 46 patients in the Kaplan-Meier survival analysis. Young patients (less than 30 years old) seemed to have a better prognosis and survival rate than older patients (more than 30 years old) (log-rank test, P=0.008). However, sex (P=0.675), extent of resection (P=0.934), postoperative radiotherapy (P=0.592), and postoperative chemotherapy (P=0.424) did not affect patient prognosis. Conclusions: The prognosis of MFH is usually poor, and most patients die within the first year after surgery. Younger MFH patients (less than 30 years old) seem to have a better prognosis and improved survival compared to older patients.
Peng Li, Qiangyi Zhou, Zhijun Yang, Zhenmin Wang, Shiwei Li, Xingchao Wang, Bo Wang, Fu Zhao, Pinan Liu. Clinical features and prognostic factors of primary intracranial malignant fibrous histiocytoma: A report of 8 cases and a literature review[J]. 临床转化神经科学, 2016, 2(3): 155-164.
Peng Li, Qiangyi Zhou, Zhijun Yang, Zhenmin Wang, Shiwei Li, Xingchao Wang, Bo Wang, Fu Zhao, Pinan Liu. Clinical features and prognostic factors of primary intracranial malignant fibrous histiocytoma: A report of 8 cases and a literature review. Translational Neuroscience and Clinics, 2016, 2(3): 155-164.
20161111172835 Table 1 Clinical features of 8 cases with primary intracranial malignant fibrous histiocytoma
20161111172848 Table 2 Results of immunohistochemical staining in 8 cases
20161111172903 Figure 1 (a, b) Bar graph depicting the sex and age distribution in a total of 62 MFH patients. (c) Kaplan-Meier plots of overall survival for 46 MFH patients. (d) Kaplan-Meier plots of overall survival for MFH patients older (dotted line) or younger (solid line) than the age of 30 years old (log-rank test, P= 0.008).
20161116191142 Figure 2 Case 1. Preoperative cranial CT shows an evident hematoma in the left occipital parietal lobe (a–c). Postoperative cranial CT shows total resection of the tumor (d & e). Pathological examination (f) reveals the diagnosis of MFH. (Hematoxylin & eosin staining, ×100)
20161116191301 Figure 3 Case 5. Preoperative cranial magnetic resonance imaging (MRI) shows a tumor lesion in the left temporal lobe. The tumor is isointense on T1-weighted image (a), and hyperintense on T2-weighted image (b). A peritumoral edema can be observed, and the brain stem is compressed. The tumor is heterogeneously enhanced after contrast administration (c–e). Pathological examination (f) reveals the diagnosis of MFH. (Hematoxylin & eosin staining, ×100)
20161116191408 Figure 4 Case 7. Preoperative cranial magnetic resonance imaging (MRI) shows a tumor lesion located at the anterior cranial fossa. The tumor is isointense on T1-weighted image (a), and hypointense on T2-weighted image (b). The tumor is heterogeneously enhanced after contrast administration (c–e). Pathological examination (f) reveals the diagnosis of MFH. (Hematoxylin & eosin staining, ×100)
20161116191520 Figure 5 Case 8. Preoperative cranial magnetic resonance imaging (MRI) shows a tumor lesion (arrow) in the posterior cranial fossa extending outward to the subcutaneous tissues (a-c). Pathological examination (d) of the resected tumor reveals the diagnosis of MFH. (Hematoxylin & eosin staining, ×100) Postoperative cranial MRI shows no remnant of the tumor (e, f). Two years after the operation, cranial MRI shows recurrence of the tumor, mainly in the subcutaneous tissues (g, h).
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2016, Vol. 2 
