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Abstract
The case of a 44-year-old man with left parotid enlargement that was initially diagnosed as cementifying fibroma is presented. The lesion was found in the deep lobe of the parotid gland and was successfully removed. Postoperatively, the patient recovered well with intact facial nerve function and remained asymptomatic after 1 year. Subsequent histology revealed the mass to be a benign fibrous tumour. The diagnosis and management of this rare entity are discussed.
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127
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Hu SW, Tsai KB, Yang SF, Lee KS, Chai CY. Unusual Solitary Fibrous Tumors in the Central Nervous System: A Report of Two Cases. Kaohsiung J Med Sci 2005; 21:179-84. [PMID: 15909674 DOI: 10.1016/s1607-551x(09)70298-0] [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: 11/18/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are uncommon, and most are found in the pleura. Extrapleural SFTs are rare and have been found in the lung, pericardium, mediastinum, soft tissue of any site, and upper respiratory tract. SFTs of the central nervous system (CNS) are very rare. The biologic features are unknown and remain poorly understood from a clinical standpoint. Most neurosurgeons do not believe that SFTs can present as primary CNS neoplasms. Most SFTs are clinically benign and indolent, and recurrences after surgical excision are scarce. Because malignant transformation or metastasis has been reported, all SFTs should be treated as having malignant potential. Long-term follow-up is recommended. We report two cases, so that surgeons may recognize that this is an entity different from other spindle-cell CNS tumors.
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128
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Abe T, Murakami A, Inoue T, Ohde S, Yamaguchi T, Watanabe K. Solitary fibrous tumor arising in the sphenoethmoidal recess: a case report and review of the literature. Auris Nasus Larynx 2005; 32:285-9. [PMID: 16054535 DOI: 10.1016/j.anl.2005.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2004] [Revised: 01/20/2005] [Accepted: 01/21/2005] [Indexed: 11/24/2022]
Abstract
Recently, solitary fibrous tumors (SFTs) have been reported in the head and neck area, such as the nasal cavity, thyroid, salivary gland, etc. We present a rare case of SFT which arose from the sphenoethmoidal recess of the nasal cavity, penetrating into the sphenoid sinus, and which showed different intensities on magnetic resonance imaging (MRI) according to the occupied locations. T2 weighted magnetic resonance (MR) images showed low intensity in the nasal cavity, and iso-intensity in the sphenoid sinus. Enhancement with gadolinium contrast on T1-weighted images was more remarkable in the sphenoid sinus than in the nasal cavity. While the tumor in the nasal cavity showed abundant collagen and high cellularity in microscopic examination, numerous small vessels and dilated vascular spaces were remarkable in the tumor of the sphenoid sinus. MRI findings corresponded to pathological findings. We review SFTs in the head and neck area in the English literature.
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129
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Hicks J. The spectrum of fibroblastic tumors: current insights--Society for Ultrastructural Pathology companion meeting at the United States and Canadian Academy of Pathology annual session in Vancouver, March 2004. Ultrastruct Pathol 2005; 28:263-4. [PMID: 15764575 DOI: 10.1080/019131290882042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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130
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Côté JF, de Saint-Maur PP, Coindre JM, Bruneval P, Badoual C. Unusual strong CD34 positivity in a thoracic monophasic fibrous synovial sarcoma. Histopathology 2005; 45:539-40. [PMID: 15500659 DOI: 10.1111/j.1365-2559.2004.01917.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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131
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Lee SC, Tzao C, Ou SM, Hsu HH, Yu CP, Cheng YL. Solitary fibrous tumors of the pleura: clinical, radiological, surgical and pathological evaluation. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2005; 31:84-7. [PMID: 15642431 DOI: 10.1016/j.ejso.2004.09.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2004] [Indexed: 10/26/2022]
Abstract
AIMS To report a clinicopathological series of cases of solitary fibrous tumor of the pleura from Taiwan. METHODS Clinical data was collected from a review of medical records and telephone interviewing for follow-up. RESULTS Eight patients, three men and five women aging from 34 to 71 years, underwent tumor resection and were followed in a period from 7 months to 13.5 years. Six patients underwent standard thoracotomy and two had VATS for tumor excision. Tumors were pathologically benign in seven patients and malignant in one. Patients were all alive with no evidence of tumor recurrence at the time of this report. CONCLUSIONS One should always consider SFTPs as potentially malignant tumors. Complete resection remains the mainstay of cure. Standard thoracotomy should always be considered when a high suspicion of malignancy is raised, whereas VATS may be a preferred approach for smaller tumors.
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Berzal-Cantalejo F, Montesinos-Carbonell M, Montesinos-Carbonell ML, Calabuig-Crespo C, Martorell-Cebollada MA. Solitary fibrous tumor arising in the fallopian tube. Gynecol Oncol 2005; 96:880-2. [PMID: 15721444 DOI: 10.1016/j.ygyno.2004.11.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises in the pleura. Although this tumor has been described at other sites, in the female genital tract it is extremely uncommon. CASE We present a case of solitary fibrous tumor arising in the fallopian tube. A 32-year-old woman who presented with acute flank pain had a presumptive diagnosis of leiomyoma of the fallopian tube after abdominopelvic ultrasound. The adnexal mass was excised laparoscopically. Histologic examination showed the characteristic features of a solitary fibrous tumor. CONCLUSION Although rare, the diagnosis of solitary fibrous tumor can be considered in the differential diagnosis of adnexal masses.
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Yu YW, Hou JG, Ma DL, Lin WH, Zhu MH. [Solitary fibrous tumor of the prostate: a case of report and review of the literature]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2005; 34:188-9. [PMID: 15938837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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134
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Abstract
An appraisal of the cytopathology and corresponding histopathology of epithelial, germ cell, and lymphoid lesions of the mediastinum was previously reported in the Journal. This report aims to complete that topic with a discussion focusing on the correlative cyto-histopathology of the major mesenchymal, neural, and neuroendocrine neoplasms from this anatomic site. As previously stated, the mediastinum remains an uncommon site for fine needle aspiration (FNA) biopsy when compared with other anatomic sites. Yet, the recent use of endoscopic ultrasound-guided FNA for sampling mediastinal masses may increase this use. The purpose of this review is to focus on the shared and dissimilar morphologic features of this subset of neoplasms to improve diagnostic correlation between the two.
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135
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Pizem J, Matos B, Popovic M. Malignant intracranial solitary fibrous tumour with four recurrences over a 30-year period. Neuropathol Appl Neurobiol 2005; 30:696-701. [PMID: 15541010 DOI: 10.1111/j.1365-2990.2004.00613.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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136
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Sung SH, Chang JW, Kim J, Lee KS, Han J, Park SI. Solitary Fibrous Tumors of the Pleura: Surgical Outcome and Clinical Course. Ann Thorac Surg 2005; 79:303-7. [PMID: 15620963 DOI: 10.1016/j.athoracsur.2004.07.013] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND The aim of this study was to define more precisely the surgical outcome and clinical course of solitary fibrous tumors of the pleura. METHODS We conducted a retrospective review of the clinical records of patients who had undergone surgical resection for benign and malignant solitary fibrous tumors of the pleura during a 10-year period (1993 to 2003). RESULTS Sixty-three patients were enrolled in the study (men, 29; women, 34; mean age, 49.6 years). Thirty-six patients (57.1%) were symptomatic at the time of diagnosis. Resection was performed through a thoracotomy (n = 37), by means of video-assisted thoracoscopy (n = 22), or through a sternotomy (n = 4). Mass excision only was performed in 34 cases, and en bloc excision including adjacent structures was performed in 29 cases. Forty-four cases (69.8%) were benign and 19 (30.2%) were malignant. Local recurrences occurred in three cases and distant metastases in eight. Recurrences occurred only in malignancy. Symptomatic presentation and the impression of a nonpleural tumor by imaging study were found to be related to a malignant pathologic diagnosis. The radiologic impression of solitary fibrous tumors of the pleura was also related to mass excision only. CONCLUSIONS For malignant cases, complete surgical resection may be insufficient for the cure. Therefore, further study should be performed to define the role of preoperative and postoperative systemic treatment.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biopsy, Fine-Needle
- Child
- Child, Preschool
- Female
- Humans
- Incidental Findings
- Life Tables
- Male
- Middle Aged
- Neoplasm Recurrence, Local
- Neoplasms, Fibrous Tissue/diagnostic imaging
- Neoplasms, Fibrous Tissue/mortality
- Neoplasms, Fibrous Tissue/pathology
- Neoplasms, Fibrous Tissue/secondary
- Neoplasms, Fibrous Tissue/surgery
- Pleural Neoplasms/diagnostic imaging
- Pleural Neoplasms/mortality
- Pleural Neoplasms/pathology
- Pleural Neoplasms/surgery
- Retrospective Studies
- Sternum/surgery
- Thoracic Surgery, Video-Assisted/statistics & numerical data
- Thoracotomy/statistics & numerical data
- Tomography, X-Ray Computed
- Treatment Outcome
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Deniz K, Kontas O, Tucer B, Kurtsoy A. Meningeal solitary fibrous tumor: report of a case and literature review. Folia Neuropathol 2005; 43:178-85. [PMID: 16245214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Solitary fibrous tumor is a rare neoplasm that most often involves the pleura. The increasing numbers of this neoplasm have also been reported to date in extrapleural sites. We report a case of a twenty-four-year-old female with right frontal mass. Histologically, the tumor composed of spindle cell proliferation. Tumor cells were found to be positive for CD34 and CD117 with immunohistochemical studies. Ten months follow-up was uneventful. Seventy seven cases of meningeal solitary fibrous tumor from the literature are analysed and pathological, immunohistochemical and clinical features are discussed. Solitary fibrous tumor has a slight female predominance, with a male to female ratio of 1:1.5. Age distribution is similar to meningioma ranging from 7-81 years. Approximately 23% of cases originate in the spine which is the most common meningeal location. Histopathologic examination shows uniform spindle cell proliferation with various amount of collagen. CD34-positivity usually allows discrimination from schwannomas, meningiomas and hemangiopericytomas. A differential diagnosis is important because most of the solitary fibrous tumors usually behave in a benign fashion. In this study, we also showed CD117 (Kit) expression in a case of meningeal SFT. CD117-positivity can be a good strategy for treatment in malignant and recurrent cases. Further investigations are necessary for therapeutic implication of CD117-positivity in SFT.
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139
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Delbecque K, Legrand M, Boniver J, Lauwers GY, de Leval L. Calcifying fibrous tumour of the gastric wall. Histopathology 2004; 44:399-400. [PMID: 15049909 DOI: 10.1111/j.1365-2559.2004.01779.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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140
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Delbecque K, Legrand M, Boniver J, Lauwers GY, de Leval L. Calcifying fibrous tumour of the gastric wall. Histopathology 2004. [PMID: 15049909 DOI: 10.1111/j.1365-2559.2004.01779.xhis1779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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141
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Coffin C, Boccon-Gibod L. Proliférations fibroblastiques et myofibroblastiques de l’enfance et de l’adolescence. Ann Pathol 2004; 24:605-20. [PMID: 15785406 DOI: 10.1016/s0242-6498(04)94022-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Fibroblastic-myofibroblastic proliferations of childhood and adolescents form a clinical and morphologic spectrum from benign reactive processes and pseudosarcomas, to fibromatoses, to various types of sarcoma. The diagnosis is challenging because of clinical and morphologic similarities, lack of specific immunohistochemical markers for different types of fibroblastic-myofibroblastic tumors, and limited molecular genetic information. Careful attention to clinical, macroscopic, and histopathologic features permits classification in most cases. This review focuses on the pathologic features of fibroblastic-myofibroblastic tumors with a predilection for children and adolescents.
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142
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Yamada H, Tsuzuki T, Yokoi K, Kobayashi H. Solitary fibrous tumor of the kidney originating from the renal capsule and fed by the renal capsular artery. Pathol Int 2004; 54:914-7. [PMID: 15598313 DOI: 10.1111/j.1440-1827.2004.01772.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Solitary fibrous tumors (SFT) are relatively rare spindle cell neoplasms that typically arise in the pleura. Recently, extrathoracic SFT that have arisen in various anatomic sites have been recognized. The histogenesis and prognosis of SFT of the kidney are not well understood because only 11 cases have been reported. We report a case of SFT of the left kidney arising from the renal capsule. The tumor was merged with the upper pole of the left renal capsule. The angiography revealed that the renal capsule artery fed the tumor. The tumor was a well-circumscribed, solid mass attached to the renal capsule without necrosis or hemorrhage. Microscopically the bland spindle cells proliferated and were accompanied by hyalinized collagenous tissue showing patternless or hemangiopericytomatous patterns. Some glomeluri and renal tubules were entrapped by the tumor cells. There were no mitotic figures. Immunohistochemically the tumor cells were diffusely positive for CD34, CD99 and bcl-2. There was no evidence of recurrence after a 4 year follow-up visit. The origin of SFT of the kidney remains uncertain. The tumor in this case merged with the renal capsule and was fed by the renal capsular artery, which suggests that some SFT of the kidney originate from the renal capsule.
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143
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Rakheja D, Wilson KS, Meehan JJ, Schultz RA, Maale GE, Timmons CF. Extrapleural benign solitary fibrous tumor in the shoulder of a 9-year-old girl: case report and review of the literature. Pediatr Dev Pathol 2004; 7:653-60. [PMID: 15630539 DOI: 10.1007/s10024-004-6065-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2004] [Accepted: 08/18/2004] [Indexed: 10/26/2022]
Abstract
We report a case of a benign solitary fibrous tumor that occurred in the right shoulder of a 9-year-old girl. This case is remarkable due to the unusual location of its occurrence and the young age of the patient. In addition, cytogenetic analysis revealed a karyotype unreported in this neoplasm: 46,XX,der(4)t(4;9)(q31.1;q34), del(9)(p22p24),der(9)t(4;9)(q31.1;q34)ins(9;?)(q34;?) (17 cells)/46,XX (3 cells).
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144
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Lo CP, Chen CY, Lin CK, Chin SC, Juan CJ, Hsueh CJ. Parasellar solitary fibrous tumor of meninges: magnetic resonance imaging features with pathologic correlation. J Neuroimaging 2004; 14:281-4. [PMID: 15228772 DOI: 10.1177/1051228403262708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Solitary fibrous tumor (SFT) is a benign mensenchymal neoplasm of spindle-cell origin. The authors report the case of a 50-year-old man with SFT arising from the meninges of the left parasellar region with cavernous sinus involvement. The tumor was demonstrated isointense on T1-weighted and heterogeneously hypointense on T2-weighted magnetic resonance imaging (MRI) with strong contrast enhancement. The preoperative MRI diagnosis was meningioma or hemangiopericytoma. Pathological study revealed an SFT that stained positive immunohistochemically for CD34 and vimentin.
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145
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Yoshimasu T, Oura S, Hirai I, Kokawa Y, Nishida M, Sasaki R, Kawago M, Yuzaki M, Tanino H, Sakurai T, Okamura Y. [Histoculture drug response assay for solitary fibrous tumor--a case report]. Gan To Kagaku Ryoho 2004; 31:1547-9. [PMID: 15508448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A 49-year-old male was referred to our hospital because of an abnormal shadow in his left lower lung field on chest X-ray. Magnetic resonance imaging scans revealed a large mass on the left diaphragm. The tumor was surgically extirpated. The tumor, encapsulated and growing from the center of the left diaphragm, measured 18 x 8 x 4 cm and weighed 440 g. Microscopic examination revealed a solitary fibrous tumor with mitotic activity of 7/ 50 hpf. Immunohistochemically, the tumor was negative for cytokeratin, s-100 protein, desmin, and alpha-smooth muscle actin, while positive for vimentin and CD34. On a histoculture drug response assay using the resected tissue, the tumor was sensitive to 5-FU, adriamycin, mitomycin C and docetaxel, and resistant to cisplatin, irinotecan, and gemcitabine.
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146
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Chen HJ, Zhang HY, Li X, Guo LX, Wei B, Guo H, Bu H, Yang K, Liu BL. [Solitary fibrous tumor: the clinicopathologic and immunohistochemical characteristics of 26 cases]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2004; 35:675-9. [PMID: 15460417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To study the clinicopathologic and immunohistochemical features of solitary fibrous tumor (SFT) and its biologic behaviour. METHODS Clinicopathologic data of 26 cases were collected and analyzed. Among them, immunohistochemical staining (Envision method) for CD34, vimentin, CD99, bcl-2, S-100, SMA, HBME-1, EMA and Ki67 were performed in 23 cases. RESULTS The 17 male and 9 female patients were between 15 and 66 years of age (mean, 44). Their SFTs were located in nose and nasopharynx, cranial cavity, soft tissue, mediastinum, and parietal and visceral pleura. The main clinical manifestations were local mass and pressure symptom. The characteristic microscopic features included patternless growth pattern, alternating hyper- and hypo-cellular areas, blunt spindle cells within keloid-like hyalinization, and hemangiopericytoma-like regions. Positive immunohistochemical staining: vimentin 100%(23/23), CD34 82%(19/23), bcl-2 87%(20/23), CD99 100%(23/23), SMA 30%(7/23). All cases were negative for S-100, HBME-1 and EMA. Follow-up information on 13 cases revealed that 3 patients had had relapse and died, the other 10 patients were alive without evidence of recurrence. CONCLUSION SFT is a rare mesenchymal spindle cell tumor which may be found in various parts of human body and needs to be distinguished from other spindle cell tumors by differential diagnosis. The immunophenotype can be of help in this connexion. About 10% to 23% SFTs have malignant behaviour, manifesting as local recurrence or metastasis. The behavior of SFT is unpredictable, which requires careful, longterm follow-up.
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147
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Hsu SS, Lai PH, Wang JS, Yip CM. Solitary fibrous tumor of the orbit. J Chin Med Assoc 2004; 67:483-6. [PMID: 15617311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
The occurrence of solitary fibrous tumor in the orbit is rare. The following is a report on the case of a 24-year-old man presented with painless, progressive proptosis of the right eye for the duration of 1 year. Computed tomography and magnetic resonance imaging demonstrated a well-circumscribed soft tissue mass with gadolinium enhancement located in the superomedial aspect of the right orbit. The patient underwent complete tumor removal through a right fronto-orbital approach, with a pathological diagnosis of solitary fibrous tumor. Postoperatively, the patient was symptom-free. From review of the literature on orbital solitary fibrous tumor, emphasis should be placed on complete tumor resection and continuous follow-up monitoring of the tumor.
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148
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Romer M, Bode B, Schuknecht B, Schmid S, Holzmann D. Solitary fibrous tumor of the orbit--two cases and a review of the literature. Eur Arch Otorhinolaryngol 2004; 262:81-8. [PMID: 15316820 DOI: 10.1007/s00405-003-0731-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2003] [Accepted: 11/20/2003] [Indexed: 01/20/2023]
Abstract
Solitary fibrous tumors of the orbit (SFT) are mesenchymal lesions that can develop either as malignant or benign neoplasias. We describe the histological features leading to the diagnosis in two females and review the current literature. Diagnosis of SFT only can be performed by histological examination, since clinical signs and radiological features are not specific enough. Even a malignant or benign course cannot be predicted, since clinical and radiological features do not correlate with histological signs of malignancy and vice versa. Radical resection is the treatment of choice, since no other treatment option has been proven to be efficient.
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149
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Kawamura M, Izawa K, Hosono N, Hirano H. Solitary Fibrous Tumor of the Spinal Cord: Case Report and Review of the Literature. Neurosurgery 2004; 55:433. [PMID: 15314822 DOI: 10.1227/01.neu.0000130037.45768.84] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE AND IMPORTANCE:
A solitary fibrous tumor (SFT) is a rare neoplasm of probable mesenchymal origin that was first reported in the pleura but can occur in different sites. Only six cases of SFT arising from the spinal cord have been reported.
CLINICAL PRESENTATION:
We report a case of primary SFT occurring in the thoracic spinal cord in a 64-year-old man with Brown-Séquard syndrome. Magnetic resonance imaging revealed an intradural mass at the level of T2–T3.
INTERVENTION:
Total T2–T3 laminectomies were performed. The tumor appeared to be adherent to the right lateral aspect of the cord but not attached to the meninges. On histological examination, the tumor exhibited spindle cell proliferation with abundant dense collagen but without a hemangiopericytomatous pattern. Immunohistochemically, the tumor cells were reactive with CD34 and vimentin only.
CONCLUSION:
We report a rare case of SFT occurring in the thoracic spinal cord. Histologically and immunohistochemically, we confirmed the diagnosis of SFT. Low signal intensity on T1- and T2-weighted images corresponded to the histological findings. When a spinal cord tumor exhibits a signal pattern similar to this, SFT should be included in the differential diagnosis. Because of the rarity of reports on this condition, the clinical manifestations and course of SFT of the spinal cord are unknown, and careful long-term follow-up is recommended.
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150
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Kim KA, Gonzalez I, McComb JG, Giannotta SL. Unusual presentations of cerebral solitary fibrous tumors: report of four cases. Neurosurgery 2004; 54:1004-9; discussion 1009. [PMID: 15046670 DOI: 10.1227/01.neu.0000115675.74366.87] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2003] [Accepted: 11/18/2003] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE Four rare cases of central nervous system solitary fibrous tumors (C-SoFTs) are described. This tumor has not previously been reported in children or in deep cortical structures. Three of these tumors occurred in the posterior fossa. Only four cases in the posterior fossa have been described previously. Nine years after its debulking from the posterior fossa, one tumor disseminated to the spine, lung, and liver. Only one such aggressive C-SoFT has been described previously. CLINICAL PRESENTATION A 7-year-old child had had 1 year of right-sided weakness at presentation. Magnetic resonance imaging scans revealed a left basal ganglia lesion. A 49-year-old woman and a 30-year-old man presented after experiencing headaches for months. Magnetic resonance imaging scans in these patients revealed a tumor in the fourth ventricle and right jugular foramen, respectively. A 55-year-old man had spinal, liver, and lung dissemination of a previous posterior fossa tumor at presentation. INTERVENTION AND TECHNIQUE All four patients underwent craniotomy for resection or subtotal removal of the tumor. Intraoperative observations noted solid well-encapsulated tumors. Immunohistochemistry confirmed C-SoFTs in all four cases. CONCLUSION C-SoFTs are rare central nervous system, typically dural-based, tumors. They frequently are overlooked in the differential diagnosis of solid central nervous system tumors. Our findings suggest that these tumors can occur at any age and in most locations, regardless of proximity to the meninges (basal ganglia and ventricle), suggesting that the cells of origin are not meningothelial, but rather the mesenchyme of the cerebral vasculature. T1- and T2-weighted magnetic resonance imaging was notable for areas of hypointensity and of hyperintensity best described as patchy or a ying-yang appearance in all cases. Delayed extracranial metastasis may be noted.
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