Diagnosis and treatment of undifferentiated pleomorphic sarcoma of colon_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CUI Ming ¹ , LIAO Quan ¹ , WANG Wenze ² ,  ZHAO Yupei ¹

1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, P. R. China;
2. Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, P. R. China;

Corresponding?author：

ZHAO Yupei, Email: zhao8028@263.net

Keywords：

colon; undifferentiated pleomorphic sarcoma; surgery; radiotherapy; chemotherapy

DOI：

10.7507/1007-9424.201710069

Video：

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Objective To explore clinical characteristics and therapeutic strategy of undifferentiated pleomorphic sarcoma of colon. Methods A retrospective study of 3 patients with undifferentiated peomorphic sarcoma of the colon was conducted. These cases were treated at the Peking Union Medical College Hospital from October 1983 to July 2016. In addition, the clinicopathologic data of 23 patients with undifferentiated pleomorphic sarcoma of colon reported in the literatures were analyzed. Results These 3 cases all received surgery in our hospital, including two patients who received postoperative radiotherapy. These three cases died of the local relapse or metastasis respectively at 5 months, 3 years, and 5 years after surgery. The 23 patients reported in the literatures were treated surgically except for 1 case, of which received chemotherapy after operation in the 2 cases, did not receive adjuvant therapy after operation in the 15 cases, were not reported clearly in the 6 cases. Sixteen cases had the results of follow-up, of which 9 cases had no recurrences or metastases and 7 cases died. Conclusions Undifferentiated pleomorphic sarcoma of colon has no specific clinical manifestation, it’s prognosis is very poor. Surgery is a main treatment for it at present. Thorough resection of tumor at an early stage is essential to patient’s recovery. Treatments such as chemotherapy and radiotherapy could be selected as postoperative adjuvant treatment, however, therapeutic schemes and effectiveness need further to be studied.

Citation： CUI Ming, LIAO Quan, WANG Wenze, ZHAO Yupei. Diagnosis and treatment of undifferentiated pleomorphic sarcoma of colon. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(4): 410-415. doi: 10.7507/1007-9424.201710069 Copy

1.	Sewell R, Levine BA, Harrison GK, et al. Primary malignant fibrous histiocytoma of the intestine: intussusception of a rare neoplasm. Dis Colon Rectum, 1980, 23(3): 198-201.
2.	Levinson MM, Tsang D. Multicentric malignant fibrous histiocytomas of the colon. Report of a case and review of the subject. Dis Colon Rectum, 1982, 25(4): 327-331.
3.	Rubbini M, Marzola A, Spanedda R, et al. Primary malignant fibrous histiocytoma of the sigmoid colon: a case report. Ital J Surg Sci, 1983, 13(4): 299-302.
4.	Waxman M, Faegenburg D, Waxman JS, et al. Malignant fibrous histiocytoma of the colon associated with diverticulitis. Dis Colon Rectum, 1983, 26(5): 339-343.
5.	Kukora JS, Bagnato J, Gatling R. Fibrous histiocytoma of colon and pancreas: report of 2 unusual cases and review of the literature. Dig Surg, 1985, 2: 180-184.
6.	Baratz M, Ostrzega N, Michowitz M, et al. Primary inflammatory malignant fibrous histiocytoma of the colon. Dis Colon Rectum, 1986, 29(7): 462-465.
7.	Yahagi K, Arai T, Matsumoto J, et al. Malignant fibrous histiocytoma of the colon with marked stenosis report of a case. Stomach Intestine, 1986, 21: 215-219.
8.	Satake T, Matsuyama M. Cytologic features of ascites in malignant fibrous histiocytoma of the colon. Acta Pathol Jpn, 1988, 38(7): 921-928.
9.	Katz RN, Waye JD, Batzel EL, et al. Malignant fibrous histiocytoma of the gastrointestinal tract in a patient with neurofibromatosis. Am J Gastroenterol, 1990, 85(11): 1527-1530.
10.	Murata I, Makiyama K, Miyazaki K, et al. A case of inflammatory malignant fibrous histiocytoma of the colon. Gastroenterol Jpn, 1993, 28(4): 554-563.
11.	Huang Z, Wei K. Malignant fibrous histiocytoma of the ascending colon in a child. Am J Gastroenterol, 1993, 88(6): 972-973.
12.	Makino M, Kimura O, Kaibara N. Radiation-induced malignant fibrous histiocytoma of the transverse colon: case report and review of the literature. J Gastroenterol, 1994, 29(6): 767-771.
13.	Hiraoka N, Mukai M, Suzuki M, et al. Malignant fibrous histiocytoma of the cecum: report of a case and review of the literature. Pathol Int, 1997, 47(10): 718-724.
14.	Udaka T, Suzuki Y, Kimura H, et al. Primary malignant fibrous histiocytoma of the ascending colon: report of a case. Surg Today, 1999, 29(2): 160-164.
15.	周建平, 蘇東明, 李繼光, 等. 結腸惡性纖維組織細胞瘤一例. 中華胃腸外科雜志, 2001, 4(4): 227.
16.	武海生. 回盲部惡性纖維組織細胞瘤 1 例. 承德醫學院學報, 2005, 22(1): 78-78.
17.	Gupta C, Malani AK. Primary malignant fibrous histiocytoma of the colon. Clin Gastroenterol Hepatol, 2006, 4(6): xxviii.
18.	Bosmans B, de Graaf EJ, Torenbeek R, et al. Malignant fibrous histiocytoma of the sigmoid: a case report and review of the literature. Int J Colorectal Dis, 2007, 22(5): 549-552.
19.	Fu DL, Yang F, Maskay A, et al. Primary intestinal malignant fibrous histiocytoma: two case reports. World J Gastroenterol, 2007, 13(8): 1299-1302.
20.	柳維軍, 陳澤, 奉孝榮. 回盲部惡性纖維組織細胞瘤臨床病理觀察. 實用醫院臨床雜志, 2010, 7(3): 130-131.
21.	劉波, 王聰, 王琳. 結腸惡性纖維組織細胞瘤伴腹膜后巨大脂肪瘤 1 例. 醫學信息 (中旬刊), 2011, 24(3): 970-971.
22.	徐曉, 歐陽斌燊, 路名芝, 等. 橫結腸原發多形性惡性纖維組織細胞瘤/未分化高級別多形性肉瘤 1 例. 臨床與實驗病理學雜志, 2012, 28(2): 231-232.
23.	張逸, 張繼, 田為中. 結腸惡性纖維組織細胞瘤一例. 中華臨床醫師雜志 (電子版), 2013, (15): 7288.
24.	王堅, 朱雄增. 2013 版 WHO 軟組織腫瘤新分類解讀. 中華病理學雜志, 2013, 42(6): 363-365.
25.	Ozzello L, Stout AP, Murray MR. Cultural characteristics of malignant histiocytomas and fibrous xanthomas. Cancer, 1963, 16: 331-344.
26.	Nascimento AF, Raut CP. Diagnosis and management of pleomorphic sarcomas (so-called "MFH") in adults. J Surg Oncol, 2008, 97(4): 330-339.
27.	Zagars GK, Mullen JR, Pollack A. Malignant fibrous histiocytoma: outcome and prognostic factors following conservation surgery and radiotherapy. Int J Radiat Oncol Biol Phys, 1996, 34(5): 983-994.
28.	Weiss SW, Enzinger FM. Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer, 1978, 41(6): 2250-2266.

1. Sewell R, Levine BA, Harrison GK, et al. Primary malignant fibrous histiocytoma of the intestine: intussusception of a rare neoplasm. Dis Colon Rectum, 1980, 23(3): 198-201.
2. Levinson MM, Tsang D. Multicentric malignant fibrous histiocytomas of the colon. Report of a case and review of the subject. Dis Colon Rectum, 1982, 25(4): 327-331.
3. Rubbini M, Marzola A, Spanedda R, et al. Primary malignant fibrous histiocytoma of the sigmoid colon: a case report. Ital J Surg Sci, 1983, 13(4): 299-302.
4. Waxman M, Faegenburg D, Waxman JS, et al. Malignant fibrous histiocytoma of the colon associated with diverticulitis. Dis Colon Rectum, 1983, 26(5): 339-343.
5. Kukora JS, Bagnato J, Gatling R. Fibrous histiocytoma of colon and pancreas: report of 2 unusual cases and review of the literature. Dig Surg, 1985, 2: 180-184.
6. Baratz M, Ostrzega N, Michowitz M, et al. Primary inflammatory malignant fibrous histiocytoma of the colon. Dis Colon Rectum, 1986, 29(7): 462-465.
7. Yahagi K, Arai T, Matsumoto J, et al. Malignant fibrous histiocytoma of the colon with marked stenosis report of a case. Stomach Intestine, 1986, 21: 215-219.
8. Satake T, Matsuyama M. Cytologic features of ascites in malignant fibrous histiocytoma of the colon. Acta Pathol Jpn, 1988, 38(7): 921-928.
9. Katz RN, Waye JD, Batzel EL, et al. Malignant fibrous histiocytoma of the gastrointestinal tract in a patient with neurofibromatosis. Am J Gastroenterol, 1990, 85(11): 1527-1530.
10. Murata I, Makiyama K, Miyazaki K, et al. A case of inflammatory malignant fibrous histiocytoma of the colon. Gastroenterol Jpn, 1993, 28(4): 554-563.
11. Huang Z, Wei K. Malignant fibrous histiocytoma of the ascending colon in a child. Am J Gastroenterol, 1993, 88(6): 972-973.
12. Makino M, Kimura O, Kaibara N. Radiation-induced malignant fibrous histiocytoma of the transverse colon: case report and review of the literature. J Gastroenterol, 1994, 29(6): 767-771.
13. Hiraoka N, Mukai M, Suzuki M, et al. Malignant fibrous histiocytoma of the cecum: report of a case and review of the literature. Pathol Int, 1997, 47(10): 718-724.
14. Udaka T, Suzuki Y, Kimura H, et al. Primary malignant fibrous histiocytoma of the ascending colon: report of a case. Surg Today, 1999, 29(2): 160-164.
15. 周建平, 蘇東明, 李繼光, 等. 結腸惡性纖維組織細胞瘤一例. 中華胃腸外科雜志, 2001, 4(4): 227.
16. 武海生. 回盲部惡性纖維組織細胞瘤 1 例. 承德醫學院學報, 2005, 22(1): 78-78.
17. Gupta C, Malani AK. Primary malignant fibrous histiocytoma of the colon. Clin Gastroenterol Hepatol, 2006, 4(6): xxviii.
18. Bosmans B, de Graaf EJ, Torenbeek R, et al. Malignant fibrous histiocytoma of the sigmoid: a case report and review of the literature. Int J Colorectal Dis, 2007, 22(5): 549-552.
19. Fu DL, Yang F, Maskay A, et al. Primary intestinal malignant fibrous histiocytoma: two case reports. World J Gastroenterol, 2007, 13(8): 1299-1302.
20. 柳維軍, 陳澤, 奉孝榮. 回盲部惡性纖維組織細胞瘤臨床病理觀察. 實用醫院臨床雜志, 2010, 7(3): 130-131.
21. 劉波, 王聰, 王琳. 結腸惡性纖維組織細胞瘤伴腹膜后巨大脂肪瘤 1 例. 醫學信息 (中旬刊), 2011, 24(3): 970-971.
22. 徐曉, 歐陽斌燊, 路名芝, 等. 橫結腸原發多形性惡性纖維組織細胞瘤/未分化高級別多形性肉瘤 1 例. 臨床與實驗病理學雜志, 2012, 28(2): 231-232.
23. 張逸, 張繼, 田為中. 結腸惡性纖維組織細胞瘤一例. 中華臨床醫師雜志 (電子版), 2013, (15): 7288.
24. 王堅, 朱雄增. 2013 版 WHO 軟組織腫瘤新分類解讀. 中華病理學雜志, 2013, 42(6): 363-365.
25. Ozzello L, Stout AP, Murray MR. Cultural characteristics of malignant histiocytomas and fibrous xanthomas. Cancer, 1963, 16: 331-344.
26. Nascimento AF, Raut CP. Diagnosis and management of pleomorphic sarcomas (so-called "MFH") in adults. J Surg Oncol, 2008, 97(4): 330-339.
27. Zagars GK, Mullen JR, Pollack A. Malignant fibrous histiocytoma: outcome and prognostic factors following conservation surgery and radiotherapy. Int J Radiat Oncol Biol Phys, 1996, 34(5): 983-994.
28. Weiss SW, Enzinger FM. Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer, 1978, 41(6): 2250-2266.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and treatment of undifferentiated pleomorphic sarcoma of colon

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