A rare case of primary malignant fibrous histiocytoma: a sarcoma of the kidney.

BACKGROUND: Primary malignant fibrous histiocytoma of the kidney (MFH) is an extremely rare tumor which is indistinguishable from its' mimics in particular renal cell carcinoma (RCC) by clinical features and preoperative imaging evaluation. Due to its high predilection to local recurrence and distant metastases, early diagnosis has great value. CASE PRESENTATION: Herein, we describe a 62 year-old man with a 3-month history of abdominal discomfort and a palpable right loin mass whom computerized tomography (CT) showed a large heterogeneous solid mass in the right kidney. With the suspicious to RCC; the patient underwent radical nephrectomy. However, histopathological report revealed pleomorphic-storiform malignant fibrous histiocytoma. Immunohistochemistry study was also confirmed the diagnosis of MFH. Six month follow up showed no evidence of any recurrence. CONCLUSIONS: The therapeutic options for MFH differ from other renal tumors, hence histopathology and immunohistochemistry studies are required to establish a definite diagnosis of the disease. Despite of progress made in clinical studies and advances in diagnostic modalities, early diagnosis of MFH has not achieved yet. Further studies and accumulated experience with renal MFH are required to determine the approach to prolong survival in selected cases along with management and prognostic factors of such tumors.

Patients' Attitude toward Breaking Bad News; a Brief Report.

INTRODUCTION: Delivering bad news is a stressful moment for both physicians and patients. The purpose of this investigation was to explore the patients' preferences and attitudes toward being informed about the bad news. METHODS: This cross-sectional study was done on patients admitted to Imam Khomeini Hospital, Sari, Iran, from September 2014 to February 2015. Patient attitude regarding breaking bad news was evaluated using a reliable and valid questionnaire. RESULTS: 130 patients were evaluated (61.5% male, mean age = 46.21 ± 12.1 years). 118 (90.76%) participants believed that the patient himself/herself should be informed about the disease's condition. 120 (92.30%) preferred to hear the news from a skillful physician and 105 (80.76%) believed that emergency department is not a proper place for breaking bad news. CONCLUSION: Based on the results of the present study, most participants believed that the most experienced and skillful physician should inform them completely regarding their medical condition. At the same time they declared that, it is best to hear bad news in a calm and suitable place and time rather than emergency department or hospital corridors during teaching rounds.