骨悪性線維性組織球腫転移症例の検討

Analysis of the Cases with Metastatic Malignant Fibrous Histiocytoma of Bone

　抄録：転移を生じた骨悪性線維性組織球腫（MFH）8例（男性4例，女性4例，初診時年齢19～79歳，平均44.5歳）の臨床像および治療成績について検討した．転移発生時期について1例は初診時に肺転移がすでにみられていたが，他の7例は初診後3～43カ月，平均20.1カ月で転移が生じた．転移部位は7例に肺転移がみられ，3例にみられた肺外転移は脊椎，軟部（大腿皮下），リンパ節に生じた．治療は転移に対して手術，化学療法，放射線療法が単独あるいは併用で施行された．結果は肺転移の7例は転移後2～24カ月，平均8.7カ月で全例死亡したが，肺転移治療症例群は未治療症例群よりも平均生存期間は長く，肺外転移治療では長期生存が得られた症例，麻痺の回復など生活の質の向上を得た症例がみられた．以上より，MFH転移症例の予後は不良であるが，できうる限り転移に対する治療を考慮するべきと思われた．

　Eight cases with metastatic malignant fibrous histiocytoma of bone (MFH) were reviewed. The average age at the first examination was 44.5 years (range, 19-79) with four males and four females. One case exhibited pulmonary metastasis when first seen and metastasis occurred in the seven cases three to 43 months (ave. 20.1) after the first examination. The metastatic sites were lung (seven cases), bone (two cases), soft tissue (one case) and lymph node (one case) . Six cases were treated for metastatic lesions. The case with only bone metastasis obtained long term survival by radiotherapy. The other seven cases died of the pulmonary metastasis (average survival 8.7 months after the metastasis). The outcome of the four cases with the treatment for the pulmonary metastasis was better than the three cases that ware not treated. In conclusion, treatment for metastatic MFH should be considered whenever possible to improve the prognosis and the patientis quality of life.