A case of primary malignant fibrous histiocytoma of the duodenum.

BACKGROUND

Primary malignant fibrous histiocytoma (MFH) of the duodenum is rare and a distinct clinical entity.

METHODS

A 55-year-old man presented with a history of upper gastrointestinal bleeding, vomiting and decreased body weight over the past 2 months. Abdominal exam showed an epigastric mass of 10 cm. An upper gastrointestinal endoscopy documented a tumor in the third part of duodenum. The histopathological examination of biopsy has concluded a MFH. Abdominal CT revealed a large and heterogeneous mass of 10 cm in the third part of the duodenum. The intervention was conducted by way of a bi-subcostal laparotomy. Exploration of the tumor revealed involvement of the third part of duodenum. This lesion adhered and invaded the inferior vena cava. A palliative procedure using a gastro-entero-anastomosis was carried out with uneventful postoperative course. Neither adjuvant chemotherapy nor radiotherapy were conducted. The patient died four months following his operation.

CONCLUSIONS

The biological behavior of malignat fibrous histiocytomas is extremely aggressive and mainly conditioned by size and histological grading. The treatment of choice, whenever possible, is based on early and complete surgical excision of the tumor.