Primary Renal Malignant Fibrous Histiocytoma Four-Case Report and Review of the Literature

OBJECTIVE To evaluate the diagnosis and treatment for primary renal malignant fibrous histiocytoma, a rare tumor arising from the kidney.

METHODS The clinical and pathological data from 4 cases of malignant fibrous histiocytoma of the kidney detected in our hospital are described. One case of special interest involved a giant cell subtype, the first to be reported in the oncology literature. The clinicopathologic features and prognostic factors of this tumor were analysed and summarized after reviewing 55 documented cases in the English and Chinese literature.

RESULTS A palpable mass (71.2%), emaciation (54.2%) and pain (54.2%) were common manifestations in renal MFH. Of all the cases, 51 were identified as a storiform-pleomorphic subtype by pathologists. In consideration of all the prognosis related factors, the residual tumor and high TNM stage predicted a shortened survival duration, but the symptom of a fever served as a better prognostic factor.

CONCLUSION Malignant fibrous histiocytoma which arises from the kidney is a rare pathologic type, and possesses a high tendency towards local recurrence and distant metastasis. Despite the poor prognosis, early detection and radical surgery can prolong survival in selected cases.