Cerebral Metastases from Malignant Fibrous Histiocytoma of Bone英文文献资料.docVIP

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Cerebral Metastases from Malignant Fibrous Histiocytoma of Bone英文文献资料.doc

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Cerebral Metastases from Malignant Fibrous Histiocytoma of Bone英文文献资料

Sarcoma(2000)4 ,125±128 CASEREPORT Cerebralmetastasesfrommalignant?broushistiocytomaofbone SUSANNEJ.ROGERSJEREMYS.WHELAN LondonBoneandSoftTissueTumourService,MiddlesexHospital,London,UK Abstract Fourpatientswithmalignant?broushistiocytomaofbone(MFH-B)metastasizingtobrainarereported.Intwocases,signs ofcerebralinvolvementdevelopedbetween4and28monthsafterdiagnosis.Bothpatientshadknownpulmonaryorbony metastases.As a consequence of this experience, two further patients were subsequently identi?ed, one with a de?nite cerebralmetastasisandonewhohadanasymptomaticsupratentoriallesion,possiblymetastatic.Itissuggestedthatpatients with MFH-B and widespread metastatic disease at presentation or developing within a short interval should undergo cerebralimaging. Keywords:malignant?broushistiocytomaofbone,brain,cerebral,metastases Introduction chemotherapy were administered, with endopros- theticreplacementoftheproximalhumerusafterthe second. Radiotherapy (60 Gy in 30 fractions) completedthetreatment.Thepatientremainedwell for11monthsbeforedevelopingpainintherightleg. Anisotopebonescanwasconsistentwithmetastases inthe?bulaandalsointhe9thrib.Localradiotherapy was given but further metastases were evident on a bone scan 2 months later, and renal and adrenal tumourdepositswereseenonabdominalCT. Three months later, she became agitated and disorientated and demonstrated inappropriate behaviour.Contrast-enhanced CT showed multiple enhancing lesions in both cerebral hemispheres. Further palliative radiotherapy was given, but the patientdied8weekslater,30monthsafterdiagnosis. Malignant ?brous histiocytoma arising in bone (MFH-B)isanuncommonbutwellde?nedprimary spindlecelltumour,predominantlyaffectingadults.1 Thetendencytoaffectlongbonesandmetastasizeto the lungencourages comparison with osteosarcoma (OS).Similarly,neoadjuvantchemotherapywiththe agents active in OS appears to improve survival in MFH-B. 2,3 In this report we describe a previously unreported metastatic site of MFH-B and d