Solitary fibrous tumor:A case report of this multifaceted tumor

BACKGROUND Solitary fibrous tumor(SFT)is a remarkably uncommon mesenchymal tumor.STAT6 level and a combination of clinical,pathological,and molecular features are required to arrive at a proper diagnosis.CASE SUMMARY In this report,we present an intriguing case involving a 43-year-old woman who initially exhibited symptoms of a bleeding retroperitoneal tumor,initially resembling a gastrointestinal stromal tumor,but later confirmed as an SFT.However,a year later,what was initially believed to be a recurrence of her SFT was instead identified as a desmoid tumor.CONCLUSION Distinguishing SFT from other tumors was pivotal.Correcting misdiagnoses of tumor type initially and of recurrence later was necessary for appropriate treatment of the correct desmoid type.

Solitary fibrous tumors in abdomen and pelvis:Imaging characteristics and radiologic-pathologic correlation

AIM: To describe the imaging features of solitary fibrous tumors (SFTs) in the abdomen and pelvis, and the clinical and pathologic correlations.

Metastatic pancreatic solitary fibrous tumor: A case report

BACKGROUND Solitary fibrous tumor(SFT)is a rare mesenchymal tumor that is most commonly found in the pleura but can also originate from non-pleural sites.Among the nonpleural localizations,the pancreas is extremely rare.In particular,metastasis to the pancreas from the central nervous system(CNS)is extremely rare,with only two cases reported so far.We report a case of recurrence in the pancreas 14 years after the initial complete surgical removal of a tumor in the CNS.CASE SUMMARY A 68-year-old man with a past medical history of recurrent meningeal hemangiopericytoma,currently referred to as SFT,presented to the hospital with jaundice.The patient was first diagnosed with an 8cm-sized meningeal hemangiopericytoma fourteen years ago and underwent osteoplastic craniotomy.After 16 mo,imaging showed recurrence and he underwent gamma knife radiosurgery(GKRS).2 years later,imaging showed recurrence again leading to a second GKRS.5 years later,recurrence was again suspected leading to a second craniotomy.Since then 3 years had passed,and imaging showed a 3.5cm-sized mass lesion on the pancreatic head with obstruction of the pancreatic and bile ducts.Endosonography with fine-needle aspiration biopsy was done preoperatively and aided in the diagnosis of SFT.The patient underwent pyloruspreserving pancreaticoduodenectomy.Pathologic findings of the resected pancreatic specimen,consistent with the previously resected brain specimen,confirmed the diagnosis of SFT.CONCLUSION The rarity and lack of knowledge about SFTs make suspecting and diagnosing this disease challenging.We believe that a report of metastatic pancreatic SFT from the CNS will contribute to a better understanding of this rare disease.

Clinicopathological analysis of solitary fibrous tumor

Objective:The aim of this study was to investigate the clinicopathologic characteristics,diagnosis and differential diagnosis,molecular genetics,treatment and prognosis of solitary fibrous tumor(SFT).Methods:The clinicopathological manifestations were analyzed retrospectively in 22 patients with surgically confirmed SFT.Results:There were 12 male patients and 10 female patients,with the age range 33-67(mean 48.62) years.The SFTs originated from different from parts of the body,including 13 in the chest,2 in the lungs,3 in the abdomen,1 in the lumbosacral area,2 in the pelvis,and 1 in the left shoulder.There were 19 benign and 3 malignant tumors.Major clinical presentations were local masses and compression symptoms.Microscopy:the tumor was composed of areas of alternating hypercellularity and hypocellularity.The tumor cells were spindle to short-spindle shaped and arranged in fascicular or storiform pattern and hemangiopericytoma-like structure was presented.Immunohistochemically,Vimentin positive rate was 100%(22/22),Bcl-2 positive rate was 95.5%(21/22),CD99 positive rate was 86.4%(19/22),CD34 positive rate was 81.8(18/22),focally positive for P53,as well as negative CK,S100 and Desmin.Ki67 labelling index was 2%-30%.Conclusion:SFT is a rare tumor which may be found in various parts of human body.SFT mostly is a benign tumor,but a few could be malignant.Its diagnosis mainly rely on its morphologic features and immunohistochemical profiles.The major treatment is to completely resect it by operation and long-term clinical follow-up is necessary.

Solitary Fibrous Tumor of the Kidney Treated with Laparoscopic Partial Nephrectomy: A Case Report

We herein reported a 27-year-old woman with a right renal mass for two years.She underwent laparoscopic partial nephrectomy.Immunohistochemical examination of the specimen confirmed the diagnosis of solitary fibrous tumor by revealing its positive staining for cluster of differentiation(CD)34,epithelial membrane antigen(EMA),B-cell lymphoma-2(Bcl-2)and CD99 in the tumor cells.No adjuvant treatment was carried out.The patient was in good health without local recurrence or metastasis during 2 years of follow-up.Laparoscopic partial nephrectomy for renal solitary fibrous tumor is an alternative treatment to radical nephrectomy.It can provide a good outcome.However,further follow-up and more cases of renal solitary fibrous tumor treated with laparoscopic partial nephrectomy are necessary to compare the oncological outcome with radical nephrectomy.

Calcifying fibrous tumor of the gastrointestinal tract: A clinicopathologic review and update

Calcifying fibrous tumor(CFT)is a rare mesenchymal lesion that has been documented throughout the gastrointestinal tract.Gastrointestinal CFTs may occur at virtually any age,with a predilection for adults and for females.They occur most commonly in the stomach and the small and large intestines.CFTs are most often found incidentally,cured by local resection,and have a low risk of recurrence.Histology shows three characteristic features:Spindle cell proliferations within a densely hyalinized stroma,scattered calcifications,and lymphoplasmacytic inflammation.CFTs are immunoreactive for CD34,vimentin and factor XIIIa,helping to distinguish them from other benign mesenchymal neoplasms.The differential diagnosis of CFTs includes sclerosing gastrointestinal stromal tumor,leiomyoma,schwannoma,solitary fibrous tumor,inflammatory myofibroblastic tumor,plexiform fibromyxoma,fibromatosis,sclerosing mesenteritis,and reactive nodular fibrous pseudotumor.The pathogenesis of CFTs remains unclear,but some have hypothesized that they may be linked to IgG4-related disease,inflammatory myofibroblastic lesions,hyaline vascular type Castleman disease,sclerosing angiomatoid nodular transformation of the spleen,or trauma.

Malignant solitary fibrous tumor involving the liver

Solitary fibrous tumors are predominantly benign and are most commonly found in the thoracic cavity and pleura; while reports exist in the literature of malignant solitary fibrous tumors and those located in extrathoracic organs, these cases are considered extremely rare. Herein, a case is reported of a malignant solitary fibrous tumor involving the liver that was diagnosed and treated in a 62-year-old woman. The patient presented with complaints of upper abdominal pain and unintentional weight loss. Computed tomography scan of the abdomen revealed a remarkably large mass, measuring 15 cm × 10 cm × 20 cm, which appeared to be unrelated to any particular organ. The intraoperative finding of a wide communication with the left liver suggested hepatic origin, and served as an indicator for tumor resection via left hemihepatectomy. The diagnosis of solitary fibrous tumor and its malignant nature was confirmed by histological and immunohistochemical examination of the resected tissues. Hepatic solitary fibrous tumor is very rare, and surgery remains the mainstay of treatment. Due to limited reports of such tumors in the literature, little can be said about the benefit of adjuvant therapy and prognosis for the rare cases with malignant histological findings.

Near-infrared fluorescence imaging of a solitary fibrous tumor of the pancreas using methylene blue

A 67-year-old female presented with unexplained abdominal pain. A contrast-enhanced computed tomography scan of the abdomen incidentally revealed a mass in the uncinate process of the pancreas. This mass was resected and based on histopathological findings, diagnosed as a solitary fibrous tumor (SFT) of the pancreas. A SFT is an extremely rare benign mesenchymal tumor that in 65% of cases affects the visceral pleura but can also affect extra-pleural sites. The intraoperative demarcation of pancreatic tumors, such as SFTs, can bechallenging. In this report, the first clear intraoperative identification of a SFT of the pancreas in a human was shown using near-infrared fluorescence and methylene blue.

Solitary fibrous tumor of the pancreas:Case report and review of the literature

Solitary fibrous tumor(SFT) is a mesenchymal tumor typically located in the pleura,but can also be found as an asymptomatic mass in other areas,including the liver,peritoneum,kidney and salivary glands.However,SFT rarely locates in the pancreas.We present such a case of pancreatic SFT,along with a review of all reported cases.A 55-year-old man was treated surgically for an asymptomatic pancreatic mass after a rigorous preoperative control.Histologic examination of the resected specimen showed characteristics of an SFT.As only 15 cases of pancreatic SFT have been reported so far,an attempt to compare the cases was considered intriguing.We found that patients with pancreatic SFT were mainly women(81.25%),with a median age of 54 years at the time of diagnosis and a median tumor size of 5.83 cm.Pancreatic SFTs were revealed incidentally in 50% of cases,and all of them showed an enhancement through arterial computed tomography.All tumors were positive for CD34,ten were positive for Bcl-2,and twelve were negative for S100.The diagnosis of this pancreatic tumor is established by a combination of clinical suspicion,imaging procedures and histological findings,and is confirmed by immunohistochemical staining.Although the behavior of SFTs is rather benign,close clinical follow-up is recommended due to a potentially malignant nature.

Giant solitary fibrous tumor arising from greater omentum

Extrathoracic solitary fibrous tumors(SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from greater omentum.Computed tomography revealed a 15.8 cm × 21.0 cm solid mass located at superior aspect of stomach.Open laparotomy confirmed its mesenchymal origin.Microscopically,its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei,which were divided up by branching vessel and collagen bundles.Immunohistochemical staining showed that this tumor was negative for CD117,CD99,CD68,cytokeratin,calretinin,desmin,epithelial membrane antigen,F8 and S-100,but positive for CD34,bcl-2,α-smooth muscle actin and vimentin.The patient presented no evidence of recurrence during follow-up.SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers,especially for CD34 and bcl-2 positive cases.

Solitary fibrous tumor of the liver expressing CD34 and vimentin:A case report

A case of a successfully treated solitary fibrous tumor (SFT) of the liver is reported.An 82-year-old female presented with left upper abdominal discomfort,a firm mass on palpation,and imaging studies revealed a large tumor,15 cm in diameter,arising from the left lobe of the liver.A formal left hepatectomy was performed.Microscopic evaluation showed spindle and fibroblast-like cells within the collagenous stroma.Immunohistochemistry disclosed diffuse CD34 and positive vimentin,supporting the diagnosis of a benign SFT.The patient remained well 21 months after surgery.SFT of the liver is a very rare neoplasm of mesenchymal origin.In most cases it is a benign lesion,although some may have malignant histological features and recur locally or metastasize.With less than 30 reported cases in the literature,little can be said regarding its natural history or the benefits of adjuvant radiochemotherapy.Complete surgical resection remains the cornerstone of its treatment.

Doege-Potter syndrome by malignant solitary fibrous tumor of the liver: A case report and review of literature

BACKGROUND Solitary fibrous tumor of the liver (SFTL) is a rare occurrence with a low number of cases reported in literature. SFTL is usually benign but, 10%-20% cases are reported to be malignant with a tendency to metastasize. The majority of malignant SFTL cases are associated with a paraneoplastic hypoglycaemia defined as Doege-Potter syndrome. Surgery is the best therapeutic treatment, however, long- life follow-up is recommended. CASE SUMMARY A 74-year-old man, was admitted to the emergency department after a syncopal episode with detection of hypoglycaemia resistant to medical treatment. The computed tomography revealed a solid mass measuring 15 cm of the left liver. An open left hepatectomy was performed with complete resection of tumor. Histopathological analyses confirmed a malignant SFTL. CONCLUSION Large series with long-term follow-up have not been published neither have clinical trials been undertaken. Consequently, the methodical long-term followup of surgically treated SFTLs is strongly recommended.

Intracranial malignant solitary fibrous tumor metastasized to the chest wall:A case report and review of literature

BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is uncommon.We reported the first case of intracranial malignant SFT metastasized to the chest wall.CASE SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss.His medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years old.An unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain tumor.Finally,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest wall.We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall.We notified him and his family of the disease,and offered palliative care.He passed away on the 29 th hospital day.CONCLUSION This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.

Obstructive jaundice caused by secondary pancreatic tumor from malignant solitary fibrous tumor of pleura:A case report

A 77-year-old man on systemic chemotherapy against postoperative bilateral multiple lung metastases of malignant solitary fibrous tumor of the pleura suffered from pruritus and jaundice. Blood examination showed elevated levels of hepatobiliary enzymes. Abdominal computed tomography showed a tumor with peripheral enhancement in the pancreatic head, accompanied with the dilatation of intra- and extra-hepatic bile ducts. He was diagnosed as having obstructive jaundice caused by a pancreatic head tumor. The pancreatic head tumor was presumably diagnosed as the metastasis of malignant solitary fibrous tumor of the pleura, because the findings on the pancreatic head tumor on abdominal CT were similar to those on the primary lung lesion of malignant solitary fibrous tumor of the pleura. The pancreatic tumor grew rapidly after the implantation of metallic stent in the inferior part of the common bile duct. The patient died of lymphangitis carcinomatosa of the lungs. Autopsy revealed a tumor that spread from the pancreatic head to the hepatic hilum. Microscopically, spindle-shaped cells exhibiting nuclear atypicality or division together with collagen deposition were observed. Immunohistochemically the pancreatic head tumor cells were negative for staining of α-smooth muscle actin （α-SMA） or CD117, but positive for vimentin, CD34 and CD99. These findings are consistent with those on malignant solitary fibrous tumor of the pleura. We report the first case of obstructive jaundice caused by a secondary pancreatic tumor from malignant solitary fibrous tumor of the pleura.

Malignant solitary fibrous tumor of the pancreas with systemic metastasis: A case report and review of the literature

BACKGROUND Pancreatic solitary fibrous tumor(SFT) is a rare neoplasm of intermediate biological potential. So far, only 22 cases have been reported since 1999. All the cases, except one, exhibited benign features. Here, we report the first case of malignant pancreatic SFT with typical Doege-Potter syndrome, along with the clinical and pathologic evidence of its systemic metastasis.CASE SUMMARY The patient was a 48-year-old man with a 1-year history of pancreatic and liver masses and refractory hypoglycemia. Increased uptake of the tracer fluorodeoxyglucose(FDG) was found in the liver and bones by fluorine-18 FDG positron emission tomography/computed tomography. After multidisciplinary discussion, a distal pancreatectomy procedure was performed, and histological examination showed a lesion composed of abundant heterogeneous spindle cells with localized necrosis. On immunohistochemistry evaluation, STAT6 was found to be diffusely expressed in the tumor. Based on the overall evidence, the patient was diagnosed with malignant pancreatic SFT with liver and bone metastases.CONCLUSION The diagnosis of malignant SFT requires comprehensive evidence including clinical, immunohistochemistry, and histological features. This case may be presented as a reference for diagnoses and management of malignant pancreatic SFTs with systemic metastasis.

Extrapleural solitary fibrous tumor of the thyroid gland: A case report and review of literature

BACKGROUND Solitary fibrous tumor(SFT)is an uncommon mesenchymal neoplasm that arises from the pleura.A few SFTs have also been described in extrapleural sites.However,SFT of the thyroid gland is rare.Here,we report a case of extrapleural SFT on the thyroid gland,in addition to a literature review.CASE SUMMARY A 59-year-old man visited our hospital in July 2017 complaining of a large mass in his neck.His thyroid function test results,including antibody levels,were within the normal limits.Ultrasonography showed a 4.7 cm×4.0 cm×3.2 cm solitary mass of intermediate suspicion in the left thyroid lobe.A fine-needle aspiration biopsy was subsequently performed.The pathologist reported a benign follicular lesion.However,the size of this nodule increased to 5.5 cm×5.0 cm×3.4 cm by April 2018.After a multidisciplinary discussion,a left lobectomy was performed in May 2018.The specimen showed a well-demarcated,partly encapsulated,soft nodule of whitish and tan/brown color on the cut surface.Light microscopy revealed high cellularity with moderate cytologic atypia.The mitotic count was 5/10 high-power fields.There was no tumor necrosis or lymphovascular invasion.The tumor was CD34-positive and signal transducer and activator of transcription 6-positive.Neither thyroid transcription factor-1 nor cytokeratin expression was detected.The Ki-67 showed intermediate proliferative activity.The final diagnosis was extrapleural SFT of the thyroid gland with a clear resection margin.The patient was discharged without complication three days after the surgery.CONCLUSION In the literature,extrapleural SFT of the thyroid gland has been reported to behave indolently with the capacity for recurrence and rare metastasis,although surgical resection is the treatment of choice.Understanding this disease entity is important for accurate diagnosis and proper management.

A Large Solitary Fibrous Tumor of the Mediastinum

Alarge solitary fibrous tumor in an adult woman＇s mediastinum accompanied by distress and shortness of breath is described.We believe that a tumor of this large size in the mediastium has rarely been reported in the world literature.

Solitary fibrous tumor of the liver

BACKGROUND: Solitary fibrous tumor of the liver is a rare neoplasm. So far, 23 cases have been described in the English literature. We reported an additional case. METHODS: A 46-year-old woman presented with abdominal mass for 2 weeks. Both abdominal sonography and CT scan showed a solid mass occupying the right lobe of the liver. Right lobectomy was performed and the tumor was resected. RESULTS: Pathological examination showed spindle cell and fibroblast-like cells within the collagenous troma. On immunohistochemical staining, these spindle tumor cells showed diffusely CD34 positive reactivity. The post-operative course was uneventful. The patient recovered smoothly, and was alive half a year without evidence of disease recurrence. CONCLUSIONS: The proper diagnosis was depended on CD34 immunohistochemical study. The number of solitary fibrous tumor of the liver reported to date is too limited to confirm the definite prognosis of the tumor.

Solitary fibrous tumor of the liver:A case report and review of the literature

BACKGROUND Hepatic solitary fibrous tumor(SFT)is a rare neoplasm.Up to now,only 90 cases have been reported in the English language literature.This report describes a case of SFT of the liver misdiagnosed as hepatocellular carcinoma.CASE SUMMARY A 42-year-old male had a two-year history of a gradually enlarging intrahepatic nodule.The preoperative imaging revealed a mass with a size of 2.7 cm×2.3 cm located in the segment IV of the liver.The patient was subjected to the resection of the segment IV,such as the medial segment of the left lobe of the liver.The histological examination of the mass showed various spindled cells irregularly arranged in the stroma.The immunohistochemistry of this mass revealed a positive staining for CD34 and STAT6.The history of intracranial tumor and postoperative pathological results led to the diagnosis of SFT of the liver(SFTL)due to a metastasis from the brain.CONCLUSION SFTL is an uncommon mesenchymal neoplasm that can be easily overlooked or misdiagnosed.The best treatment choice is the complete surgical resection of the mass.A regular follow-up after the surgery should be performed due to the poor prognosis of metastatic or recurrent SFT.

Malignant solitary fibrous tumor of the greater omentum: A case report and review of literature

BACKGROUND Malignant solitary fibrous tumors(SFTs)account for 15%-20%of all SFTs,and malignant SFTs arising from the greater omentum are extremely rare.Most malignant SFTs of the greater omentum are diagnosed via pathological examinations after surgery.In this study,we report a case of malignant omental SFT and review the published literature on this rare malignancy.CASE SUMMARY A 64-year-old female presented with an abdominal mass,and underwent exploratory surgery,during which a huge tumor originating from the greater omentum and intraperitoneal implants were identified and resected.The results of the pathological examination,immunohistochemistry staining,and gene sequencing led to the diagnosis of malignant SFT of the greater omentum.The patient died one and a half years later due to tumor recurrence and metastasis.CONCLUSION This is the first report of the application of gene sequencing in the diagnosis of malignant SFTs of the greater omentum.