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Wei YC, Li CF, Sung MT, Chen YT, Ko SF, Eng HL, Huang HY. Primary myxoid solitary fibrous tumor involving the seminal vesicle. Pathol Int 2006; 56:642-4. [PMID: 16984624 DOI: 10.1111/j.1440-1827.2006.02022.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although focal myxoid change is a well-recognized feature of solitary fibrous tumor (SFT), predominantly myxoid SFT are exceedingly rare. Reported herein is the case of a 65-year-old man with SFT containing abundant myxoid matrix, arising from the capsule of the right seminal vesicle. To the authors' knowledge this is the first myxoid SFT involving the male genito-urinary system. Recognition of the myxoid variant of SFT is crucial, given possible confusion with a variety of myxoid spindle cell neoplasms with different biological potential in the pelvic cavity.
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MESH Headings
- 12E7 Antigen
- Aged
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Antigens, CD34/genetics
- Antigens, CD34/metabolism
- Carcinoma/diagnosis
- Carcinoma/metabolism
- Carcinoma/pathology
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/metabolism
- Diagnosis, Differential
- Gene Expression Regulation, Neoplastic/genetics
- Genital Neoplasms, Male/diagnosis
- Genital Neoplasms, Male/metabolism
- Genital Neoplasms, Male/pathology
- Humans
- Male
- Neoplasms, Fibrous Tissue/diagnosis
- Neoplasms, Fibrous Tissue/metabolism
- Neoplasms, Fibrous Tissue/pathology
- Proto-Oncogene Proteins c-bcl-2/genetics
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Seminal Vesicles/metabolism
- Seminal Vesicles/pathology
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77
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Al-Sayyad A, Cagiannos I. Fibrous pseudotumor of the epididymis and tunica vaginalis. THE CANADIAN JOURNAL OF UROLOGY 2006; 13:3279-80. [PMID: 17076952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We present a case of fibrous pseudotumor of the epididymis and tunica vaginalis which is one of the rarest paratesticular tumors. Fibrous pseudotumor presents as a solid scrotal mass with normal serum markers. Pathological examination is the only reliable way to make the diagnosis with these tumors exhibiting characteristic macroscopic and microscopic features. It is important to recognize this entity since local excision is the treatment of choice and orchiectomy is unnecessary.
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78
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Clarençon F, Bonneville F, Sichez JP, Khalil I, Poirier J, Chiras J. Localisation atypique d’une tumeur fibreuse solitaire dans le quatrième ventricule. J Neuroradiol 2006; 33:279-80. [PMID: 17041540 DOI: 10.1016/s0150-9861(06)77281-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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79
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80
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Krishnadas R, Froeschle PO, Berrisford RG. Recurrence and malignant transformation in solitary fibrous tumour of the pleura. Thorac Cardiovasc Surg 2006; 54:65-7. [PMID: 16485194 DOI: 10.1055/s-2005-865902] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Solitary fibrous tumours of the pleura are mesenchymal neoplasms and recurrence with malignant progression after complete resection rarely occurs. In the case of a 76-year-old patient we found multifocal recurrence with malignant transformation within six months following primary excision. Even though the vast majority of these tumours are benign, complete resection as well as clinical and radiological follow-up are highly recommended because of the potentially adverse biological behaviour and the lack of radical treatment options other than surgery.
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81
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Abstract
A case of giant cell angiofibroma in a 73-year-old man is reported. The tumour was located in the upper-inner quadrant of the right orbit and recurred 16 months after surgical removal. The clinicopathological features of this rare neoplasm--that is nowadays considered a variant of solitary fibrous tumour--are reviewed and briefly commented on.
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82
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Alvarado-Cabrero I, Hernández S, Kelly G J, Cuenca-Buele S. [Pleura's solitary fibrous tumor. Clinical pathology analysis of 17 cases]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2006; 44:397-402. [PMID: 17207398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Solitary fibrous tumor of the pleura (SFTP) is a rare neoplasm that usually originates from the visceral pleura, but it can occur in a wide range of tissues. Approximately 12% of pleural cases are malignant tumors and surgical excision usually become curative. The objective of this study is to present 17 new cases of SFTP and analyze the morphological characteristics that help to identify tumors with a malignant behavior. MATERIAL AND METHODS We did a retrospective review of the patients who had primary pleural tumors from January 1995 to August 2005. RESULTS Among a total of 94 primary pleural tumors, 17 patients were enrolled in this study, 8 men and 9 women, with a mean age of 63 years. Thirteen cases (76%) were benign and four cases (23%) were malignant. Local recurrences occurred in three cases. There were no metastases found. Recurrences occurred only in malignancy tumors. All malignant tumors were high cellularity and had hemiangiopericitic pattern, more than 4 mitoses per 10 high power fields, and moderate to marked polymorphism. CONCLUSIONS SFTP shows a benign biologic outcome in most of the cases. There are some histological characteristics that led to distinguish between benign and malign neoplasm.
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83
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Koroku M, Tanda H, Katoh S, Onishi S. [Solitary fibrous tumor of a kidney: a case report]. HINYOKIKA KIYO. ACTA UROLOGICA JAPONICA 2006; 52:705-6. [PMID: 17040055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We report a case of solitary fibrous tumor (SFT) arising from a kidney. The patient was an 18-year-old female who visited our hospital with the complaint of left abdominal pain. Computed tomography revealed a slightly enhanced tumor of approximately 3 cm in diameter near the upper calyx of the left kidney. Renal cell carcinoma was suspected, and left nephrectomy was performed under laparoscopy. Histopathological examination revealed proliferation of CD34-positive spindle-shaped cells, and a diagnosis of SFT was made. There has been no local recurrence or distant metastasis for 15 months after the operation.
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84
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Trabelsi A, Mestiri S, Mokni M, Stita W, Ikram B, Sriha B, Korbi S. [Extra-thoracic solitary fibrous tumor. Report of 2 cases]. LA TUNISIE MEDICALE 2006; 84:585-8. [PMID: 17263209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The solitary fibrous tumor (SFT), is an unusual entity, first described in the pleura, but can involve other serosal surfaces and viscera. We report two cases of extra-thoracic SFT involving the retro-peritoneum and the upper arm. Extra-thoracic TFS is a rarily wide morphologic and evolutive spectrum.
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85
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Yamada N, Okuse C, Nomoto M, Orita M, Katakura Y, Ishii T, Shinmyo T, Osada H, Maeda I, Yotsuyanagi H, Suzuki M, Itoh F. Obstructive jaundice caused by secondary pancreatic tumor from malignant solitary fibrous tumor of pleura: A case report. World J Gastroenterol 2006; 12:4922-6. [PMID: 16937484 PMCID: PMC4087636 DOI: 10.3748/wjg.v12.i30.4922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
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.
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86
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Mahesh B, Clelland C, Ratnatunga C. Recurrent localized fibrous tumor of the pleura. Ann Thorac Surg 2006; 82:342-5. [PMID: 16798253 DOI: 10.1016/j.athoracsur.2005.09.057] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Revised: 09/05/2005] [Accepted: 09/20/2005] [Indexed: 12/16/2022]
Abstract
Localized fibrous tumors of the pleura are rare. They are often asymptomatic and may have symptoms based on size, bronchial invasion, or hormone production, or a combination of these. Complete resection offers the best chance of cure. However, recurrence is reported in a significant number of patients and can often be treated by repeated resection, albeit with increasing difficulty. We present a case in which delayed recurrence occurred after excision of such a tumor. This required a chest-wall resection and reconstruction after which a second recurrence occurred. Further thoracotomy including a latissimus dorsi free flap procedure was needed for a third-time recurrence.
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88
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Papi G, Corrado S, LiVolsi VA. Primary spindle cell lesions of the thyroid gland; an overview. Am J Clin Pathol 2006; 125 Suppl:S95-123. [PMID: 16830961 DOI: 10.1309/4dqw6rqx3c6krx1j] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Spindle cell lesions of the thyroid gland (T-SCL) are not encountered routinely in clinical practice or in the context of thyroid pathology. They commonly are classified as primary or secondary to metastatic disease. Primary T-SCL can be derivedfromfollicular, C-cell (parafollicular), or mesenchymal components and may be the result of reactive or neoplastic processes, including post-fine-needle aspiration spindle cell nodules, Riedel thyroiditis, solitary fibrous tumor, leiomyoma, peripheral nerve sheath tumor, hyalinizing trabecular tumor, spindle epithelial tumor with thymus-like differentiation, follicular dendritic cell tumor, medullary carcinoma, papillary carcinoma, anaplastic carcinoma, sarcoma, squamous cell carcinoma, and carcinoma showing thymus-like differentiation. Because T-SCL may represent the expression of benign and highly malignant neoplasms, distinction among these processes is crucial because it dictates therapy and defines prognosis. The present article reviews the clinical, imaging, pathologic, and immunohistochemical characteristics of primary T-SCL.
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89
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Gessi M, Lauretti L, Fernandez E, Lauriola L. Intraventricular solitary fibrous tumor: a rare location for a rare tumor. J Neurooncol 2006; 80:109-10. [PMID: 16699874 DOI: 10.1007/s11060-006-9154-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Accepted: 03/21/2006] [Indexed: 10/24/2022]
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90
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García Torrelles M, Beltrán Armada JR, Santolaya García I, Carrascosa Lloret V, Tarín Planes M, San Juan De Laorden C. [Solitary fibrous tumor of the tunica vaginalis testis]. ARCH ESP UROL 2006; 59:186-9. [PMID: 16649526 DOI: 10.4321/s0004-06142006000200011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We report one case of solitary fibrous tumor of the tunica vaginalis, a benign paratesticular lesion. METHODS Surgical exploration with intraoperative biopsy and excision of the lesion was undertaken, leaving the testicle and epididymis undamaged. RESULTS Intraoperative biopsy revealed the presence of fibrous tissue without malignant cellularity. Pathological diagnosis on the surgical specimen was solitary fibrous tumor of the tunica vaginalis. The patient remains asymptomatic and disease-free one year after treatment. CONCLUSIONS Almost all testicular masses are malignant, but in order to avoid a non-indicated orchyectomy, one should be cautious with the finding of a paratesticular lesion of probable benign nature on ultrasound or during surgery.
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91
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Daigeler A, Lehnhardt M, Langer S, Steinstraesser L, Steinau HU, Mentzel T, Kuhnen C. Clinicopathological findings in a case series of extrathoracic solitary fibrous tumors of soft tissues. BMC Surg 2006; 6:10. [PMID: 16824225 PMCID: PMC1523192 DOI: 10.1186/1471-2482-6-10] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Accepted: 07/06/2006] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFT) represent a rare entity of soft tissue tumors. Previously considered being of serosal origin and solely limited to the pleural cavity the tumor has been described in other locations, most particularly the head and neck. Extrathoracic SFT in the soft tissues of the trunk and the extremities are very rare. Nine cases of this rare tumor entity are described in the course of this article with respect to clinicopathological data, follow-up and treatment results. METHODS Data were obtained from patients' records, phone calls to the patients' general practitioners, and clinical follow-up examination, including chest X-ray, abdominal ultrasound, and MRI or computed tomography. RESULTS There were 6 females and 3 males, whose age at time of diagnosis ranged from 32 to 92 years (mean: 62.2 years). The documented tumors' size was 4.5 to 10 cm (mean: 7 cm). All tumors were located in deep soft tissues, 3 of them epifascial, 2 subfascial, 4 intramuscular. Four tumors were found at the extremities, one each at the flank, in the neck, at the shoulder, in the gluteal region, and in the deep groin. Two out of 9 cases were diagnosed as atypical or malignant variant of ESFT. Complete resection was performed in all cases. Follow-up time ranged from 1 to 71 months. One of the above.mentioned patients with atypical ESFT suffered from local relapse and metastatic disease; the remaining 8 patients were free of disease. CONCLUSION ESFT usually behave as benign soft tissue tumors, although malignant variants with more aggressive local behaviour (local relapse) and metastasis may occur. The risk of local recurrence and metastasis correlates to tumor size and histological status of surgical resection margins and may reach up to 10% even in so-called "benign" tumors. Tumor specimens should be evaluated by experienced soft tissue pathologists. The treatment of choice is complete resection followed by extended follow-up surveillance.
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92
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Balduyck B, Lauwers P, Govaert K, Hendriks J, De Maeseneer M, Van Schil P. Solitary fibrous tumor of the pleura with associated hypoglycemia: Doege-Potter syndrome: a case report. J Thorac Oncol 2006; 1:588-90. [PMID: 17409923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Tumor-associated hypoglycemia as a paraneoplastic phenomenon is a well-known entity and is referred to as Doege-Potter syndrome. A man was admitted because of acute confusion and drowsiness. Laboratory results showed profound hypoglycemia. All investigations proved to be normal, except for a chest x-ray, which showed a large pleural mass. On transthoracic puncture, a tumor of pleural origin was diagnosed. This tumor, presenting as a large, well-circumscribed encapsulated mass, was removed by thoracotomy. On pathologic examination, the diagnosis of a solitary fibrous tumor with benign characteristics was made. After surgical removal, the hypoglycemia resolved. Solitary fibrous tumors are localized tumors of the pleura with an unpredictable behavior. The therapy consists of resection.
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93
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Cardinale L, Allasia M, Ardissone F, Borasio P, Familiari U, Lausi P, Rubino A, Solitro F, Fava C. CT features of solitary fibrous tumour of the pleura: experience in 26 patients. Radiol Med 2006; 111:640-50. [PMID: 16791467 DOI: 10.1007/s11547-006-0062-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 03/29/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to identify the typical computed tomography (CT) features of solitary fibrous tumours of the pleura (SFTP) and determine which findings would allow confirmation of the pleural origin or benign behaviour of the tumour. MATERIALS AND METHODS Twenty-six preoperative CT studies of the chest (23 enhanced and 14 unenhanced) were retrospectively reviewed. RESULTS Up to 50% of SFTP were larger than 10 cm. At unenhanced CT, they showed homogeneous attenuation in 5 cases (35.7%) and inhomogeneous attenuation in 9 (64.3%). At contrast-enhanced CT, they were inhomogeneous in 21 cases (91.3%), with geographic pattern (61.9% of cases), serpiginous linear areas of enhancement (intralesional vessels) (23.8%), rounded (52.4%) or linear (33.3%) areas of low attenuation (necrosis). CONCLUSIONS Depending on location, size and histological features, SFTP may produce a large spectrum of findings. Typical CT features of small SFTP were well-defined margins and smooth contours, homogeneous attenuation and right or obtuse angles with the pleura. Larger lesions were characterised by well-defined margins and lobulated contours, geographic pattern in enhanced CT scans, acute angles or smooth tapering margins with the pleura.
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94
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Patsios D, Hwang DM, Chung TB. Intraparenchymal solitary fibrous tumor of the lung: an uncommon cause of a pulmonary nodule. J Thorac Imaging 2006; 21:50-3. [PMID: 16538158 DOI: 10.1097/01.rti.0000186995.92705.64] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Solitary fibrous tumor of the lung is a rare mesenchymal tumor entity that has been characterized histologically. Its CT features have not been described before in the radiologic literature. We present the clinical, radiologic, and imaging features of a solitary fibrous tumor of the lung. The lesion we describe demonstrated slow growth and well defined margins. Specifically, we demonstrate its avid heterogeneous enhancement following intravenous contrast administration. Although rare, the diagnosis should be considered in asymptomatic slow growing pulmonary nodules with similar features.
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95
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de Ribaupierre S, Meagher-Villemure K, Agazzi S, Rilliet B. Meningeal solitary fibrous tumour in a child. Childs Nerv Syst 2006; 22:619-22. [PMID: 16416152 DOI: 10.1007/s00381-005-0042-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Revised: 07/22/2005] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Meningeal solitary fibrous tumour is a relatively recent pathological entity that has rarely been described in children. With radiological techniques, it cannot be distinguished from meningiomas, and the diagnosis has to be confirmed histologically. CASE REPORT We discuss the possible histogenesis of this tumour and the need for recognizing this lesion as a separate entity. We report the case of a 12-year-old boy who developed a meningeal solitary fibrous tumour; the main clinical symptoms were progressive headaches for a long period and recent transient hemiparesis. CONCLUSION This child presents an uneventful evolution without additional therapy 3.5 years after surgery.
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96
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Oguro S, Tanimoto A, Jinzaki M, Akita H, Yashiro H, Okuda S, Kuribayashi S, Kameyama K, Mukai M. Imaging findings of solitary fibrous tumor of the prostate: a case report. Magn Reson Imaging 2006; 24:673-5. [PMID: 16735192 DOI: 10.1016/j.mri.2005.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Accepted: 12/19/2005] [Indexed: 11/19/2022]
Abstract
The imaging findings of a solitary fibrous tumor of the prostate are presented. A 35-year-old male presented with urinary retention and was found on transrectal ultrasonography to have a hypoechoic tumor of the prostate, measuring 5.5 cm in size. Magnetic resonance imaging on, the tumor showed low signal intensity on T1-weighted images and heterogeneous mixed signal intensity on T2-weighted images. Gadolinium-enhanced dynamic study showed gradual enhancement from the periphery to the center, and the enhancement is sustained. On immunohistochemistry, the spindle cells of the tumor showed positive staining for CD34 and bcl-2. Although the tumor was labeled as a low-grade malignancy on account of a low mitotic index (MIB-1 index) of about 5%, the patient developed local recurrence of the tumor with bladder wall invasion 12 months later.
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97
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Roccia F, Tavolaccini A, Daniele D, Berrone S. Enlarging lesion of the upper eyelid. J Oral Maxillofac Surg 2006; 64:943-8. [PMID: 16713810 DOI: 10.1016/j.joms.2006.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2005] [Indexed: 11/22/2022]
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98
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Ganly I, Patel SG, Stambuk HE, Coleman M, Ghossein R, Carlson D, Edgar M, Shah JP. Solitary Fibrous Tumors of the Head and Neck. ACTA ACUST UNITED AC 2006; 132:517-25. [PMID: 16702568 DOI: 10.1001/archotol.132.5.517] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To describe the clinicopathologic and radiologic features of solitary fibrous tumors of the head and neck. DESIGN Retrospective analysis. SETTING Tertiary referral center that performs head and neck surgical oncology. PATIENTS Twelve patients with solitary fibrous tumors of the head and neck identified from the pathology and soft tissue tumor databases at Memorial Sloan-Kettering Cancer Center, New York, NY, from 1990 to 2004. All cases were reviewed by 3 experienced pathologists, 1 of whom is an experienced soft tissue tumor pathologist. The diagnosis was confirmed by microscopic features on hematoxylin-eosin staining and by positive staining for CD34 and Bcl2 on immunohistochemical analysis. Tumors were scored for mitotic activity, cellularity, nuclear pleomorphism, necrosis, and the presence of a malignant component. Details on patient characteristics, tumor characteristics, previous treatment and surgery, adjuvant treatment, and outcome were recorded from clinical records. RESULTS Solitary fibrous tumors occurred in patients over a wide age range (27-78 years; median age, 52 years). Seven patients (58%) were women, and 5 (42%) were men. Most tumors presented as a slow-growing painless mass with a duration ranging from 2 months to 5 years. The tumors ranged from 1 x 1 cm to 6 x 5 cm. Patients presented with a subcutaneous mass of the scalp or face in 4 cases, intraoral mass in 4, sinonasal mass in 3, and paraspinal mass in 1. Computed tomographic and/or magnetic resonance imaging scans of 7 of the 12 patients showed well-circumscribed tumors that enhanced strongly with contrast. Treatment for all of the patients was surgical resection. Pathologic findings showed that 9 tumors were benign and 3 were malignant. Three patients had a positive surgical resection margin. All patients were alive at a median follow-up of 8 months (range, 1-76 months). Local recurrence occurred in 1 patient who had positive surgical margins 3 years after the initial surgery. CONCLUSIONS Solitary fibrous tumors of the head and neck region are rare and most commonly benign. The diagnosis depends on microscopic and immunohistochemical features, although imaging may help. Patients with these tumors can be safely treated with local excision, but tumors with positive margins require close follow-up over several years owing to the potential for late local recurrence.
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99
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White WM, Hilsenbeck J, Waters WB. Fibromatous periorchitis of testis. Urology 2006; 67:623.e15-6. [PMID: 16527591 DOI: 10.1016/j.urology.2005.09.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Revised: 09/07/2005] [Accepted: 09/29/2005] [Indexed: 11/22/2022]
Abstract
Fibrous pseudotumors of the tunica vaginalis, epididymis, and spermatic cord are uncommon benign paratesticular masses. An extremely rare variant termed "fibromatous periorchitis" exhibits diffuse proliferative encasement of the testis and manifests grossly as an indurated testis reminiscent of malignancy. We present the case of a 25-year-old man who presented with a grossly abnormal testicular examination and benign scrotal ultrasound findings and pathologic evidence of fibromatous periorchitis. The natural history, gross and histologic findings, and management of fibrous pseudotumors and fibromatous periorchitis are discussed.
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Abstract
Calcifying fibrous tumor (CFT) is an uncommon lesion of uncertain cause and pathogenesis that has a unique histological appearance. These lesions are described mainly in the subcutaneous or deep soft tissues, followed by subserosal locations. Intrinsic visceral CFT is extremely rare. Herein is described a rare case of CFT that involved the gastric wall, along with a review of the literature. An incidental small polypoid lesion was excised during urgent surgery for penetrating injury at the lesser curvature in a 25-year-old man, previously healthy. The lesion was a well-demarcated, small (10 mm) tumor that occupied the submucosa. The characteristic histopathological features and the presence of spindle cells that express factor XIIIa allowed a diagnosis of CFT to be made. The present case and the review revealed that, despite their frequent subperitoneal location, intra-abdominal CFT might present as intrinsic visceral lesions and might be found incidentally. These lesions tend to be smaller when compared to their symptomatic counterparts. The diffuse factor XIIIa expression in CFT might be useful to differentiate this entity from other intra-abdominal soft-tissue tumors in problematic cases. Although rarity of intrinsic visceral CFT necessitates new cases to determine their exact biological behavior, the present case highlights their presence in the stomach as a symptomless small polypoid lesion.
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