Subscribe to RSS
DOI: 10.1055/s-2001-15003
Das Kompartmentsyndrom als Komplikation eines Malignen
Fibrösen Histiozytoms des Oberschenkels
- Eine Fallvorstellung und Literaturübersicht -
Compartmental syndrom of the lower extremity as complication of a femoral Maligneous Fibrous Histiozytoma (MFH) - a case report and review of literature.
Publication History
Publication Date:
31 December 2001 (online)
![](https://www.thieme-connect.de/media/viszeralchirurgie/200103/lookinside/thumbnails/10.1055-s-2001-15003-1.jpg)
Zusammenfassung.
Das Maligne Fibröse Histiozytom (MFH) ist die häufigste bösartige Weichgewebsneoplasie des höheren Lebensalters. Diagnosestellung und konsekutive Therapie erfolgen oft erst wegen Komplikationen bei fortgeschrittenem Tumorleiden. Wir berichten den Fall einer 85-jährigen Patientin mit einem Kompartmentsyndrom des linken Beins, verursacht durch die subfasziale, distal-femorale Raumforderung eines MFH Stadium III. Die Durchführung explorativer Tumorresektionen konnte die akut-vitale Bedrohung beseitigen, bevor die Patientin beim Auftreten eines zweiten lokoregionären Rezidivs einer Amputation zustimmte. Sie verstarb neun Monate nach der Erstoperation an den Folgen einer diffusen Lungenfilialisierung.
Compartmental syndrom of the lower extremity as complication of a femoral Maligneous Fibrous Histiozytoma (MFH) - a case report and review of literature.
The MFH is the most common maligneous soft tissue tumor of the elder. Diagnosis and therapy are often performed in advanced stadiums due to complications of the mass. We report the case of an 85 year old female patient with a compartment syndrom of the left limb caused by a vast subfaszial femoral MFH. Explorative resection-surgery was carried out, thous relieving the acute vital threat two times, before the patients approval to amputation on second local recurrance. Nine months following primary resection the woman died cause of lung filiae.
Schlüsselwörter:
Malignes Fibröses Histiozytom - Kompartmentsyndrom - Chirurgische Intervention
Key words:
Maligneous Fibrous Histiozytoma - Compartment Syndrom - Surgery
Literaturverzeichnis
- 1 Bertoni F. et al . Malignant fibrous histiocytoma of soft tissue. An analysis of 78 cases located and deeply seated in the extremeties. Cancer. 1985; 56 356
- 2 Casper E S. et al . Preoperative and postoperative adjuvant combination chemotherapie for adults with high grade soft tisssue sarcoma. Cancer. 1994; 73 1644
- 3 Costa J. et al . The grading of soft tissue sarcomas. Cancer. 1984; 53 530
- 4 Echtermeyer V. et al . Chirurgische Behandlung des Kompartmentsyndroms. Unfallheilkunde. 1982; 85 144
- 5 Ekfors T O, Rantakokko V. An analysis of 38 malignant fibrous histiocytomas in the extremities. Acta path microbiol scand Sect A. 1978; 86 25
- 6 Enjoji M, Hashimoto H. Diagnosis of soft tissue sarcomas. Path Res Pract. 1984; 178 215
- 7 Enzinger F M, Weiss S W. Soft tissue tumors. Mo, Mosby; 3rd ed, St. Louis 1995: 351
- 8 Fletcher C DM. Pleomorphic malignant fibrous histiocytoma: fact or fiction?. Am J Surg Path. 1992; 16 (3) 213
- 9 Fu Y S. et al . Malignant soft tissue tumors of probable histocytic origin. Cancer. 1975; 35 176
- 10 Gawenda M. et al . Das Compartmentsyndrom unter besonderer Berücksichtigung gefäßchirurgischer Aspekte. Zent bl Chir. 1992; 117 432
- 11 Huhn D, Meister P. Malignant Histiocytosis. Morphological and cytochemical findings. Cancer. 1978; 42 1341
- 12 Kearney M M. et al . Malignant fibrous histiocytoma. A retrospective study of 176 cases. Cancer. 1980; 45 167
- 13 Le-Doussal V. et al . Prognostic factors for patients with localized primary malignant fibrous histiocytoma. A multycenter study of 216 patients with multivariate analysis. Cancer. 1996; 77 (9) (3) 1823
- 14 Matsen F A. et al . Diagnosis and management of compartmental syndrome. J Bone Joint Surgery. 1980; 62 (A) 286
- 15 Meister P. et al . Malignant fibrous histiocytoma: histomorphological pattern or tumor type. Pathol Res Pract. 1996; 192 (8) 877
- 16 Merck C, Angervall L. et al . Myxofibrosarcoma: A malignant soft tissue tumor of fibroblastic-histiocytic origin. Acta Pathol Microbiol Immunol Scand A. 1983; 91 1
- 17 Mubarak S. et al . Double-incision fasciotomy of the leg for decompression in compartimental syndromes. J Bone Joint Surgery. 1997; 59-A (2) 184
- 18 Mubarak S. et al . Acute compartment syndromes. Surg Clin North Amer. 1983; 63 539
- 19 O'Brian J E, Stout A P. Malignant fibrous xanthomas. Cancer. 1964; 17 1445
- 20 Pezzi C M. et al . Prognostic factors in 227 patients with malignant fibrous histiocytoma. Cancer. 1992; 69 2098
- 21 Riede H N, Wehner H. Allgemeine und spezielle Pathologie. Stuttgart, New York; Georg Thieme Verlag 1989: 863
- 22 Rööser B. et al . Malignant fibrous histiocytoma of soft tissue. A population-based epedemiologic and prognostic study of 137 patients. Cancer. 1990; 67 499
- 23 Salo J C. et al . Malignant fibrous histiocytoma of the extremity. Cancer. 1999; 85 (8) 1765
- 24 Sadoski C. et al . Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissue. J Surg Oncol. 1993; 52 223
- 25 Simon M A, Emmerling W F. The management of soft tissue sarcomas of the extremities. J Bone Joint Surg. 1976; 58A 317
- 26 Singer S. et al . Prognostic factors predictive of survival and local recurrance for extremity soft tissue sarcoma. Ann Surg. 1994; 219 165
- 27 Spiro I. et al . Combined surgery and radiation therapy for limb preservation in soft tissue sarcoma of the extremity. Cancer invest. 1995; 13 86
- 28 Steuer B. The management of soft tissue tumors. Int Orthop (SICOT). 1978; 1 28
- 29 Szyszkowitz R. et al . Äthiologie, Pathophysiologie und anatomische Lokalisation des Kompartment-Syndroms. Langenbecks Arch Chir. 1982; 358 215
- 30 Tanabe K T. et al . Influence of surgical margins on outcome in patients with preoperatively irradiated extremity soft tissue sarcomas. Cancer. 1994; 73 (No. 6) 1652
- 31 Weiss S W. et al . Malignant fibrous histiocyztoma. An analysis of 200 cases. Cancer. 1978; 41 225
- 32 Zagars G K. et al . Malignant Fibrous Histiocytoma: outcome and prognostic factors following conservation surgery and radiotherapy. Int J Radiat Oncol Biol Phys. 1996; 34 (5) 983
Dr. med. Volker Lacher
St. Marienkrankenhaus
Abteilung für Unfallchirurgie
Gallwitzallee 123 - 143
12249 Berlin
Phone: 030-76783-326
Fax: 030-76783-777