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 ra...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.展开更多
We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. H...We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. Histologically, the tumor was diagnosed as a cellular variant of solitary fibrous tumor of the pleura, with branching “staghorn” vessels and hypervascularity. The tumor thus resembled a chest wall hemangiopericytoma.展开更多
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 path...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.展开更多
Background: Solitary fibrous tumors of the pleura (SFTP) are rare neoplasms with unpredictable behavior. Lack of unifying criteria for benign or malignant SFTP has resulted in reports of SFTP exhibiting malignant beha...Background: Solitary fibrous tumors of the pleura (SFTP) are rare neoplasms with unpredictable behavior. Lack of unifying criteria for benign or malignant SFTP has resulted in reports of SFTP exhibiting malignant behavior years after complete surgical resection (despite benign initial diagnosis). Additionally, the role of trans-thoracic needle biopsy in initial management of SFTP is unclear. Understanding predictors of malignancy identifies patients at unacceptably high risk for non-surgical primary therapy, and for recurrence despite complete surgical resection. Objectives: The primary objectives were to identify clinicopathological predictors of malignancy & recurrence in SFTP. The secondary aim was to determine the role of trans-thoracic needle biopsy in the management decision algorithm of SFTP. Methods: Retrospective chart review was conducted (Jan. 1983-Dec. 2013) at the Ottawa Hospital for pathologically confirmed SFTP. Data were collected on biopsy-related, clinical, histopathological & immunohistochemistry (IHC) variables. Appropriate tests of statistical inference were conducted for all variables. Results: Pathologically confirmed SFTP was identified in 26 cases. Transthoracic needle biopsy was conducted in 22 (84.6%);with 16 (72.7%) biopsies diagnostic of SFTP with IHC;3 (13.6%) being malignant. Primary management was surveillance in 3 and complete surgical resection in 23. Surgical pathology reported 15 (65.2%) benign and 8 (34.8%) malignant cases. Local recurrence occurred in 3 and distant recurrence in 1. Initial pathology was benign in 3 (75%) with recurrence. Clinicopathologic variables analyzed did not predict recurrent disease. IHC features did not differ between malignant & benign pathology significantly. Predictors of malignant pathology included: infiltrative cellular pattern (p = 0.042), nuclear crowding (p = 0.006), tumour necrosis (p 4 mitoses/ 10 high power field (p Conclusion: Because numerous variables analyzed did not predict recurrent disease, long-term follow-up is warranted regardless of benign or malignant initial histology. Histologic not IHC features predicted malignant pathology. Trans-thoracic needle biopsy did identify malignant SFTP;however its main use should be to differentiate SFTP from other pleural neoplasms using IHC.展开更多
We report a case of a patient presenting with profound insulin-independent hypoglycaemia. A large hepatic leasion was identified and surgically resected. Histology confirmed a 17.5 cm hepatic solitary fibrous tumour. ...We report a case of a patient presenting with profound insulin-independent hypoglycaemia. A large hepatic leasion was identified and surgically resected. Histology confirmed a 17.5 cm hepatic solitary fibrous tumour. The clinical and biochemical presentation is consistent with IGF-II mediated hypoglycaemia.展开更多
A 42-year-old male with a history of recurrent intracranial hemangiopericytoma presented to the Emergency Department with urinary retention. Ensuing work-up revealed a 10-centimeter circumscribed pelvic mass that appe...A 42-year-old male with a history of recurrent intracranial hemangiopericytoma presented to the Emergency Department with urinary retention. Ensuing work-up revealed a 10-centimeter circumscribed pelvic mass that appeared anatomically distinct from the sacrum. This metastasis was found 10 years after the initial resection of his intracranial lesion. An abdominal resection was performed, and the patient recovered uneventfully. Final pathology and staining findings were consistent with metastatic hemangiopericytoma. Hemangiopericytoma is a rare mesenchymal soft tissue neoplasm with potential for late local recurrence and metastasis. Here, we review the case and discuss the clinical relevance of narrowing the diagnosis to HPC or the growing umbrella of Solitary Fibrous Tumor (SFT). To our knowledge, this is the first report of intracranial HPC metastatic to the pelvis.展开更多
Fat-forming variant of solitary fibrous tumor （fat-forming variant of SFT）, previously called lipomatous hemangiopericytoma （L-HPC）, is a recently recognized rare variant of solitary fibrous tumor （SFT） with unp...Fat-forming variant of solitary fibrous tumor （fat-forming variant of SFT）, previously called lipomatous hemangiopericytoma （L-HPC）, is a recently recognized rare variant of solitary fibrous tumor （SFT） with unpredictable biologic behavior. Fat-forming variant of SFT occurs predominately in the deep soft tissues of the lower extremities. Histologically, it is composed of an admixture of benign hemangiopericytomatous and lipomatous components. Up to now,展开更多
Background:Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor.They are infrequently encountered in the orbital region while th...Background:Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor.They are infrequently encountered in the orbital region while the zygomatic bone is an extremely rare location for these neoplasms to occur.Case presentation:A 14-year-old boy presented with complaint of deformity of left infraorbital area and a firm,regular mass in the region.Orbital CT scan revealed a well-defined round isodense intraosseous lesion in the lowermost portion of the lateral orbital wall(zygomatic bone),expanding the bone and protruding anteriorly and medially.MRI showed the mass to be heterogenous and strongly enhancing with contrast medium.Inferior transconjunctival orbitotomy was performed and the mass was removed.The histopathologic examination and immunohistochemistry staining results(positive for CD34,CD31 and smooth muscle actin,but negative for CD99,S100,B-cell lymphoma 2(bcl-2)and desmin)confirmed the diagnosis of hemangiopericytoma.The postoperative course was uneventful,with no evidence of recurrence after 5 years follow up.Conclusions:This case represents the second hemangiopericytoma reported in the zygomatic bone.Although extremely rare,hemangiopericytoma/solitary fibrous tumor might be considered in the differential diagnosis of intraosseous lesions of the orbital and zygomatic region.展开更多
文摘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.
文摘We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. Histologically, the tumor was diagnosed as a cellular variant of solitary fibrous tumor of the pleura, with branching “staghorn” vessels and hypervascularity. The tumor thus resembled a chest wall hemangiopericytoma.
文摘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.
文摘Background: Solitary fibrous tumors of the pleura (SFTP) are rare neoplasms with unpredictable behavior. Lack of unifying criteria for benign or malignant SFTP has resulted in reports of SFTP exhibiting malignant behavior years after complete surgical resection (despite benign initial diagnosis). Additionally, the role of trans-thoracic needle biopsy in initial management of SFTP is unclear. Understanding predictors of malignancy identifies patients at unacceptably high risk for non-surgical primary therapy, and for recurrence despite complete surgical resection. Objectives: The primary objectives were to identify clinicopathological predictors of malignancy & recurrence in SFTP. The secondary aim was to determine the role of trans-thoracic needle biopsy in the management decision algorithm of SFTP. Methods: Retrospective chart review was conducted (Jan. 1983-Dec. 2013) at the Ottawa Hospital for pathologically confirmed SFTP. Data were collected on biopsy-related, clinical, histopathological & immunohistochemistry (IHC) variables. Appropriate tests of statistical inference were conducted for all variables. Results: Pathologically confirmed SFTP was identified in 26 cases. Transthoracic needle biopsy was conducted in 22 (84.6%);with 16 (72.7%) biopsies diagnostic of SFTP with IHC;3 (13.6%) being malignant. Primary management was surveillance in 3 and complete surgical resection in 23. Surgical pathology reported 15 (65.2%) benign and 8 (34.8%) malignant cases. Local recurrence occurred in 3 and distant recurrence in 1. Initial pathology was benign in 3 (75%) with recurrence. Clinicopathologic variables analyzed did not predict recurrent disease. IHC features did not differ between malignant & benign pathology significantly. Predictors of malignant pathology included: infiltrative cellular pattern (p = 0.042), nuclear crowding (p = 0.006), tumour necrosis (p 4 mitoses/ 10 high power field (p Conclusion: Because numerous variables analyzed did not predict recurrent disease, long-term follow-up is warranted regardless of benign or malignant initial histology. Histologic not IHC features predicted malignant pathology. Trans-thoracic needle biopsy did identify malignant SFTP;however its main use should be to differentiate SFTP from other pleural neoplasms using IHC.
文摘We report a case of a patient presenting with profound insulin-independent hypoglycaemia. A large hepatic leasion was identified and surgically resected. Histology confirmed a 17.5 cm hepatic solitary fibrous tumour. The clinical and biochemical presentation is consistent with IGF-II mediated hypoglycaemia.
文摘A 42-year-old male with a history of recurrent intracranial hemangiopericytoma presented to the Emergency Department with urinary retention. Ensuing work-up revealed a 10-centimeter circumscribed pelvic mass that appeared anatomically distinct from the sacrum. This metastasis was found 10 years after the initial resection of his intracranial lesion. An abdominal resection was performed, and the patient recovered uneventfully. Final pathology and staining findings were consistent with metastatic hemangiopericytoma. Hemangiopericytoma is a rare mesenchymal soft tissue neoplasm with potential for late local recurrence and metastasis. Here, we review the case and discuss the clinical relevance of narrowing the diagnosis to HPC or the growing umbrella of Solitary Fibrous Tumor (SFT). To our knowledge, this is the first report of intracranial HPC metastatic to the pelvis.
基金the China Medical Board of New York(CMB 00-722).
文摘Fat-forming variant of solitary fibrous tumor （fat-forming variant of SFT）, previously called lipomatous hemangiopericytoma （L-HPC）, is a recently recognized rare variant of solitary fibrous tumor （SFT） with unpredictable biologic behavior. Fat-forming variant of SFT occurs predominately in the deep soft tissues of the lower extremities. Histologically, it is composed of an admixture of benign hemangiopericytomatous and lipomatous components. Up to now,
文摘Background:Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor.They are infrequently encountered in the orbital region while the zygomatic bone is an extremely rare location for these neoplasms to occur.Case presentation:A 14-year-old boy presented with complaint of deformity of left infraorbital area and a firm,regular mass in the region.Orbital CT scan revealed a well-defined round isodense intraosseous lesion in the lowermost portion of the lateral orbital wall(zygomatic bone),expanding the bone and protruding anteriorly and medially.MRI showed the mass to be heterogenous and strongly enhancing with contrast medium.Inferior transconjunctival orbitotomy was performed and the mass was removed.The histopathologic examination and immunohistochemistry staining results(positive for CD34,CD31 and smooth muscle actin,but negative for CD99,S100,B-cell lymphoma 2(bcl-2)and desmin)confirmed the diagnosis of hemangiopericytoma.The postoperative course was uneventful,with no evidence of recurrence after 5 years follow up.Conclusions:This case represents the second hemangiopericytoma reported in the zygomatic bone.Although extremely rare,hemangiopericytoma/solitary fibrous tumor might be considered in the differential diagnosis of intraosseous lesions of the orbital and zygomatic region.
