Malignant fibrous histiocytoma is a type of soft tissue carcinoma. The condition is commonly observed on the extremities, retro-peritoneum region, lungs, and even the head. The tumor sub-type determines the development of metastasis or the spread of the tumor. Clinical research reveals that metastasis is mostly observed in the lungs. The condition is characterized by a painless, consistently enlarging soft tissue mass on the body.
Basically, this condition develops from soft tissue and hence, it can appear just about anywhere on the body. The fibrous histiocytoma is also observed on areas that have been exposed to prostheses or shrapnel implantation.
Low-grade MFH tumors resemble the surrounding soft tissue, while intermediate and high-grade MFH do not. There are two clinical stages that classify the tumors:
- Stage 1, here the tumors are less than 5 centimeters in diameter.
- Stage 2, here the tumors are larger than 5 centimeters in diameter.
MFH occurs more in Caucasians, though a relationship of the abnormality with any particular geographical region is yet to be defined. Males are affected more than females. Sun-exposed parts of the body are more susceptible to the development of MFH. It has been observed that people affected with genetic diseases like neurofibromatosis are more prone to develop this condition. The condition also affects the skeletal framework of people with Paget disease or dysplasia of bone.
The condition has been linked to the chemical phenoxyacetic acid that is commonly found in herbicides, clorphenols in timber preservatives, and asbestos. Research also reveals that people who have been previously exposed to radiation are also prone to develop the symptoms of MFH.
The only immediate and direct symptom of MFH is the development of an abnormal mass. This is usually accompanied by:
- High levels of eosinophils, certain type of white blood cells
- Hypoglycemia or low blood sugar
- Liver function abnormalities that show up in various tests
The malady is best diagnosed when the tumor is removed. Prior to surgery, most symptoms are difficult to distinguish from the other soft tissue sarcomas. Once the tumor or fibrous mass has been surgically removed by the orthopedic surgeon, the diagnostic procedure involves microscopic examination of the tumor.
The treatment options for this condition are surgery, chemotherapy, or radiotherapy. Surgery involves the excision of the fibrous mass and thereafter chemotherapy and/or radiation, if required. The tumor can be detected and treated in time with the help of magnetic resonance imaging or MRI. Nevertheless, a biopsy becomes important for definitive diagnosis.
In chemotherapy the growth of tumor cells is stopped by administration of various drugs. These drugs either stop the growth of the tumor cells or kill them. These drugs are administered orally or through injections. Radiation therapy involves the use of high-energy x-rays to kill the tumor cells. The radiation therapy can be of two types; external and internal.
In external a machine is used to send high-energy radiation inside the body to kill the tumor cells. Whereas, in the internal radiation, the radioactive substance is placed inside the body, near the tumor. In this method, the radioactive material is first placed inside a sealed seed, needle, or wire before placing it inside the body.
Prognosis of the condition depends on the size of the tumor and grade. The prognosis is generally poor when the disease metastasizes to the bones or the lungs, or if the tumor removal is not successfully accomplished. Its treatment could result in loss of a limb or amputation. This adds to psycho-sociological stress that a patient may have to bear, in the absence of the right support.