Malignant fibrous histiocytoma (MFH) of the mesentery: a case report.

BACKGROUND: Primary tumors of the mesentery are rare; only a few cases of malignant fibrous histiocytoma have been reported in the literature. This case report presents the management of a patient with malignantfibrous histiocytoma of the mesentery.

CASE REPORT: A 48-year-old woman presented with mild abdominal pain and a palpable tumor in the lower abdomen. Laparatomy revealed a 12x9 cm tumor located in the mesentery and an enlargement of the paraaortic lymph nodes. The tumor was histologically classified as a malignant fibrous histiocytoma, showing a heterologeous picture consisting of large, multinucleated cells and spindle-shaped cells forming a storiform-like growth pattern. A radical excision of the tumor and the lymphnodes was performed and the patient received adjuvant irradiation therapy. Approximately three months later she presented with a great multilobated pelvic mass infiltrating the uterus and the adnexa. The patient underwent total abdominal hysterectomy and bilateral salpingo-oopherectomy to reduce the tumor mass. Two courses of palliative cytotoxic polychemotherapy were applied, but the patient died two months later due to progression of disease.

CONCLUSION: Malignant fibrous histiocytoma of the mesentery is an extremely rare, highly malignant neoplasm with early metastatic spread. The treatment of choice is wide surgical excision, while the role of adjuvant chemotherapy and irradiation still remains controversiaL