The clinical presentation of malignant fibrous histiocytoma (MFH) is not very characteristic.
In the extremities, MFH appears as a painless mass. If a malignant fibrous histiocytoma develops in the retroperitoneum (space that lies behind the peritoneum on the back in the direction of the spine), it can spread unnoticed for a long time. Only when the tumor exerts pressure on organs or nerves does it cause pain.
The following symptoms and complaints may indicate a malignant fibrous histiocytoma:
Main symptoms
- Retroperitoneal type: pain as it progresses.
- Dermal/cutaneous MFH: often broadly ulcerated (“ulcerated”) nodule in cutis (skin) and subcutis (subcutaneous) (palpable) – usually painless/poor
Associated symptoms
- Loss of appetite
- Fatigue
- Vertigo (dizziness)
- B-symptomatics (see below).
B-symptomatics
- Severe night sweats (wet hair, soaked sleepwear).
- Unexplained, persistent or recurrent fever (> 38 °C).
- Unintentional weight loss (> 10% percent of body weight within 6 months).
Localization
Typical of primary bone tumors is that they can be assigned to a characteristic localization in addition to a specific age range. They arise clustered at the sites of most intense longitudinal growth (metaepiphyseal/articular area).
The following questions should be answered by diagnostic measures:
- Localization in the skeleton → Which bone is affected?
- Localization in the bone → epiphysis* (joint end of the bone (near the joint)), metaphysis* (transition from epiphysis to diaphysis), diaphysis* (long bone shaft), central, eccentric (not central), cortical (at the solid outer shell of the bone), extracortical, intraarticular (within the joint capsule).
Malignant fibrous histiocytoma occurs particularly in the skeletal muscles and fascia of the (mainly lower) extremities (MFH of the extremities) and in the retroperitoneum (space located behind the peritoneum on the back towards the spine) (retroperitoneal type). It is also found in the long tubular bones of the femur and tibia, and rarely in the skin (dermal/cutaneous MFH) and in internal organs such as the lungs, kidneys, bladder, and scrotum.
* Example of the structure of a long bone: epiphysis – metaphysis – diaphysis – metaphysis – epiphysis.
