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García Pérez F, Contreras Jiménez A, Agredano Ávila B, Masegosa González J. Giant solitary fibrous tumor of the olfactory groove. An unusual simulator in an unusual location. NEUROCIRUGIA (ENGLISH EDITION) 2024:S2529-8496(24)00044-3. [PMID: 39074659 DOI: 10.1016/j.neucie.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 06/14/2024] [Accepted: 07/06/2024] [Indexed: 07/31/2024]
Abstract
Solitary fibrous tumors are rare mesenchymal neoplasms that can develop in any part of the body, with those that settle intracranially being confused with meningiomas as a general rule. We present the case of a 57-year-old man referred to our hospital due to bifrontal headache, anosmia, and behavioral alterations of 6 months' duration. Radiological studies revealed the existence of a large tumor mass with an extra-axial appearance and location in the anterior cranial fossa, initially compatible with a giant meningioma of the olfactory groove. Gross total resection of the mass was carried out. The pathological diagnosis was unexpected: a solitary fibrous tumor (WHO grade 1, 2021). Given the aggressive nature of these lesions, with a tendency to recurrence, malignant transformation and even metastasis, surgery with macroscopically complete resection intention should constitute the first therapeutic option. Close clinical-radiological follow-up after the procedure is justified.
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2
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Sagar M, Sunar D, Konkimalla A, Das S. Rare presentation of solitary fibrous tumour in the floor of the mouth. BMJ Case Rep 2024; 17:e258608. [PMID: 38649243 PMCID: PMC11043717 DOI: 10.1136/bcr-2023-258608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
A male in his 20s, a tobacco chewer, presented to the outpatient department with a history of painless, slowly progressive swelling in the floor of the mouth. After a thorough history and clinical examination, MRI was done and the tumour was completely excised. Histopathological examination revealed the mass to be a solitary fibrous tumour, confirmed with immunohistochemical markers. On subsequent follow-ups, the patient was found to be asymptomatic with no clinical signs of recurrence.
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Affiliation(s)
- Milind Sagar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Diwash Sunar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Abhilash Konkimalla
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Sumanta Das
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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3
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Angelico G, Salvatorelli L, Vecchio GM, Mazzucchelli M, Rosano GN, Poidomani S, Magro GG. Solitary fibrous tumor occurring at unusual sites: A clinico-pathological series of 31 cases with emphasis on its wide morphological spectrum. Pathol Res Pract 2024; 255:155207. [PMID: 38394808 DOI: 10.1016/j.prp.2024.155207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/27/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
Solitary fibrous tumor (SFT) is a relatively rare mesenchymal fibroblastic tumor occurring most commonly in adults with no gender predilection. Although the pathological diagnosis of SFT is usually straightforward, some difficulties may occasionally arise mainly due to the wide morphological spectrum exhibited by this tumor. In the present paper we aimed to evaluate the unusual clinicopathological features in a series of 31 SFTs arising from parenchymal organs, superficial soft tissues and deep soft tissues. Our results emphasize that SFTs may occur anywhere, including unusual sites such as periosteum of the thoracic spine, mesorectal tissue, hepatic hilum, paravescial space, kidney and breast. Moreover, a wide morphological spectrum was observed in tumors included in our series. The most striking morphological features observed included: extensive lipomatous component, myxoid stromal changes, epithelioid cell component, metaplastic mature bone, neurofibroma-like, myxofibrosarcoma-like and pseudoalveolar-like areas. Additionally, multinucleated giant cells and sarcomatous dedifferentiation were also identified. Our paper emphasizes that SFT may occur in unusual anatomical locations and exhibits a wide morphological spectrum. Pathologists must be aware of these features to avoid confusion with other benign and malignant neoplasms that may show overlapping morphological features.
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Affiliation(s)
- Giuseppe Angelico
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Lucia Salvatorelli
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Giada Maria Vecchio
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Manuel Mazzucchelli
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Giovanni Nunzio Rosano
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Simone Poidomani
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Gaetano Giuseppe Magro
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy.
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4
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Koca DS, Kolpakov V, Ihlow J, von Laffert M, Erb-Eigner K, Herbst H, Kriese K, Schweizer L, Bertelmann E. Prevalence of TERT Promoter Mutations in Orbital Solitary Fibrous Tumors. Curr Issues Mol Biol 2024; 46:1467-1484. [PMID: 38392213 PMCID: PMC10887834 DOI: 10.3390/cimb46020095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
The orbital manifestation of a solitary fibrous tumor (SFT) is exceptionally rare and poses specific challenges in diagnosis and treatment. Its rather exceptional behavior among all SFTs comprises a high tendency towards local recurrence, but it rarely culminates in metastatic disease. This raises the question of prognostic factors in orbital SFTs (oSFTs). Telomerase reverse transcriptase (TERT)-promoter mutations have previously been linked to an unfavorable prognosis in SFTs of other locations. We analyzed the prevalence of TERT promoter mutations of SFTs in the orbital compartment. We performed a retrospective, descriptive clinico-histopathological analysis of nine cases of oSFTs between the years of 2017 and 2021. A TERT promoter mutation was present in one case, which was classified with intermediate metastatic risk. Local recurrence or progress occurred in six cases after primary resection; no distant metastases were reported. Multimodal imaging repeatedly showed particular morphologic patterns, including tubular vascular structures and ADC reduction. The prevalence of the TERT promoter mutation in oSFT was 11%, which is similar to the prevalence of extra-meningeal SFTs of the head and neck and lower than that in other extra-meningeal compartments. In the present study, the TERT promoter mutation in oSFT manifested in a case with an unfavorable prognosis, comprising aggressive local tumor growth, local recurrence, and eye loss.
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Affiliation(s)
- David Sinan Koca
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Vladimir Kolpakov
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Jana Ihlow
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Institute of Health Charité Clinician Scientist Program, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin Institute of Health Biomedical Innovation Academy, Anna-Louisa-Karsch-Str., 210178 Berlin, Germany
| | - Maximilian von Laffert
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Diagnostics, Institute of Pathology, Universitätsklinikum Leipzig AöR, Liebigstraße 26, 04103 Leipzig, Germany
| | - Katharina Erb-Eigner
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Hermann Herbst
- Department of Pathology, Vivantes Hospital Neukölln, Vivantes Netzwerk für Gesundheit GmbH Berlin, Rudower Straße 48, 12351 Berlin, Germany
| | - Karen Kriese
- Department of Pathology, Vivantes Hospital Neukölln, Vivantes Netzwerk für Gesundheit GmbH Berlin, Rudower Straße 48, 12351 Berlin, Germany
| | - Leonille Schweizer
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, 60528 Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt-Mainz, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Frankfurt Cancer Institute (FCI), 60596 Frankfurt am Main, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
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5
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Safaei S, Kimiaei A, Çağan P, Kutlu CA. Benign Solitary Fibrous Tumor of the Pleura. Cureus 2024; 16:e54111. [PMID: 38487158 PMCID: PMC10938868 DOI: 10.7759/cureus.54111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Solitary fibrous tumors of the pleura (SFTPs) are rare and typically benign neoplasms with limited reported cases. Despite their initial characterization as a pleura-based lesion, these neoplasms can occur in various anatomical locations. These tumors can present with paraneoplastic syndromes and have potential malignant transformations. Herein, we report a case of a 47-year-old female presenting with chest pain, cough, and weakness who was subsequently diagnosed with a benign SFTP. The patient required surgical intervention and underwent a wedge resection via video-assisted thoracoscopic surgery. The patient's recovery was uneventful, demonstrating effective management.
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Affiliation(s)
| | - Ali Kimiaei
- Medicine, Bahcesehir University, Istanbul, TUR
| | - Pinar Çağan
- Thoracic Surgery, Bahcesehir University, Istanbul, TUR
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Janik AM, Terlecka A, Spałek MJ, Boye K, Szostakowski B, Chmiel P, Szumera-Ciećkiewicz A, Bobak K, Świtaj T, Rutkowski P, Czarnecka AM. Diagnostics and Treatment of Extrameningeal Solitary Fibrous Tumors. Cancers (Basel) 2023; 15:5854. [PMID: 38136399 PMCID: PMC10742263 DOI: 10.3390/cancers15245854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Solitary fibrous tumors (SFT) are rare mesenchymal neoplasms that account for less than 2% of all soft tissue masses. In the latest WHO 2020 Classification of Soft Tissue Tumors, extrameningeal SFT was listed as intermediate (rarely metastasizing) or malignant neoplasms. Due to the lack of characteristic clinical features, their diagnosis and treatment remain challenging. The pathogenesis of SFT is often associated with the presence of fusions of the NAB2-STAT6 gene on the 12q13 chromosome. Cytoplasmic CD34 positive staining is considerably characteristic for most SFTs; less frequently, factor XII, vimentin, bcl-2, and CD99 are present. A key factor in the diagnosis is the prevalent nuclear location of STAT6 expression. Radical resection is the mainstay of localized SFTs. In the case of unresectable disease, only radiotherapy or radio-chemotherapy may significantly ensure long-term local control of primary and metastatic lesions. To date, no practical guidelines have been published for the treatment of advanced or metastatic disease. Classical anthracycline-based chemotherapy is applicable. The latest studies suggest that antiangiogenic therapies should be considered after first-line treatment. Other drugs, such as imatinib, figitumumab, axitinib, and eribulin, are also being tested. Definitive radiotherapy appears to be a promising therapeutic modality. Since standards for the treatment of advanced and metastatic diseases are not available, further investigation of novel agents is necessary.
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Affiliation(s)
- Anna Maria Janik
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Terlecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Mateusz J. Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, 02-718 Warsaw, Poland
| | - Kjetil Boye
- Department of Oncology, Oslo University Hospital, 0372 Oslo, Norway;
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Paulina Chmiel
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Diagnostic Hematology Department, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Klaudia Bobak
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Tomasz Świtaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute Polish Academy of Sciences, 02-106 Warsaw, Poland
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7
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Kwok ALM, Chan JKC, Tang AHN, Luk ISC, Lau GTC, Cheuk W. Adenofibromatous Solitary Fibrous Tumor: An Unusual Morphologic Variant Occurring in the Sinonasal Tract. Head Neck Pathol 2023; 17:165-171. [PMID: 36166160 PMCID: PMC10063739 DOI: 10.1007/s12105-022-01490-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Solitary fibrous tumor can exhibit a broad morphologic spectrum, such as presence of epithelioid tumor cells, adipose cells and multinucleated giant cells. This report describes an unusual morphologic variant characterized by adenofibromatous features, all occurring in the sinonasal region. METHODS Four cases of the adenofibromatous variant of solitary fibrous tumor were retrieved from the surgical pathology and consultation files in Queen Elizabeth Hospital, Hong Kong. Histologic examination, immunohistochemical study and reverse-transcription polymerase chain reaction (RT-PCR) were performed. RESULTS The patients were adults who presented with an obstructive mass of the nasal septum, nasal cavity or nasolacrimal sac. Histologic examination showed a circumscribed biphasic tumor with intermingling of glandular structures and spindle cells, reminiscent of mammary fibroadenoma. Bland-looking spindle cells formed short, irregularly oriented fascicles, admixed with variable amount of collagen fibers. The glandular component comprised ducts and seromucinous acini with a lobular architecture, indicating that it represented exuberant hyperplasia of indigenous glands rather than part of the neoplastic process. Demonstration of CD34 and STAT6 immunoreactivity in the spindle cells and NAB2::STAT6 gene fusion by polymerase chain reaction supports the diagnosis of solitary fibrous tumor. CONCLUSION This study reports four cases of sinonasal solitary fibrous tumor with adenofibromatous features, furthermore expanding the morphologic spectrum of this tumor.
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Affiliation(s)
- Angie L. M. Kwok
- Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, China
| | - John K. C. Chan
- Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, China
| | | | - Ivy S. C. Luk
- Department of Pathology, St. Paul’s Hospital, Hong Kong, China
| | - Gene T. C. Lau
- Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, China
| | - Wah Cheuk
- Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, China
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8
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Peng L, Shang QW, Chen J, Wang Y. Solitary fibrous tumor hanging on the lung: An unusual cause of the chest pain. Asian J Surg 2023; 46:1069-1070. [PMID: 35987990 DOI: 10.1016/j.asjsur.2022.07.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lei Peng
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qian-Wen Shang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Jindong Chen
- Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Wang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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9
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Ricciardi S, Giovanniello D, Carbone L, Carleo F, Di Martino M, Jaus MO, Mantovani S, Treggiari S, Tornese A, Cardillo G. Malignant Solitary Fibrous Tumours of the Pleura Are Not All the Same: Analysis of Long-Term Outcomes and Evaluation of Risk Stratification Models in a Large Single-Centre Series. J Clin Med 2023; 12:jcm12030966. [PMID: 36769614 PMCID: PMC9918053 DOI: 10.3390/jcm12030966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 02/01/2023] Open
Abstract
Introduction: Malignant solitary fibrous tumours of the pleura (mSFTP) are extremely rare diseases (<5% of all pleural neoplasms) with unpredictable behaviour. Surgery remains the standard of care for these tumours; however, estimating patient prognosis and planning follow-up remain challenging. Several risk stratification models have been proposed, but a classification with diagnostic and prognostic potential has not been well standardised yet. The aim of this study was to analyse the clinicopathological data of mSFTP to investigate their prognostic features and to compare the performance of three risk stratification models proposed in the literature. Methods: Observational retrospective cohort study on all proven cases of mSFTP surgically resected with radical intent between 2000 and 2019 in a single centre. Demographic, surgical and pathological data were examined. All patients were risk-stratified by using three prediction models: modified Demicco, De Perrot and Tapias. Overall survival (OS) and disease-free survival (DFS) were analysed. Results: There were 21 men and 13 women (median age, 67 years, range, 23-83 years). Twenty-one patients (62%) were symptomatic. The median follow-up was 111 months (range, 6-258 months). The 5-year OS and DFS were 81.2% and 77.4%, respectively. Nine patients (26.5%) experimented recurrences. At univariate analysis, the presence of necrosis (p = 0.019), nuclear atypia (p = 0.006), dimension greater than 11.5 cm (median value of our cohort) (p = 0.037) and relapse/disease progression (p = 0.001) were independent prognostic factor of worse OS. The administration of adjuvant treatment was a protective independent factor for survival (p = 0.001). Radicality of resection (p = 0.005); tumour dimension (p = 0.013), presence of necrosis (p = 0.041) and nuclear atypia (p = 0.007) and pleural pattern (p = 0.011) were independent prognostic factors of worse DFS. Analysing the three risk stratification models, the Tapias score was revealed as the best index to predict both OS (p = 0.002) and DFS (p = 0.047) in patients with mSFTP. Conclusions: Using the risk stratification model proposed by Tapias, patients with the highest risk of recurrence could be identified at the time of surgery to establish a more frequent imaging surveillance and longer follow-up. The role of adjuvant treatment in mSFTP therapy has not been established yet, but further analysis on patients with a high risk of recurrence, stratified according to risk models, along with biomolecular panels may tailor future post-surgical therapies.
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Affiliation(s)
- Sara Ricciardi
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
- PhD Program, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
- Correspondence: ; Tel.: +39-06-5870-5607
| | - Delia Giovanniello
- Department of Cardio-Thoraco-Vascular Surgery, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Luigi Carbone
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
| | - Francesco Carleo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
| | - Marco Di Martino
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
| | - Massimo Osvaldo Jaus
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
| | - Sara Mantovani
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
- Department of Cardio-Thoraco-Vascular Surgery, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Stefano Treggiari
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
| | - Andrea Tornese
- Unit of Anatomy and Pathological Histology, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
| | - Giuseppe Cardillo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, 00151 Rome, Italy
- Unicamillus—Saint Camillus University of Health Sciences, 00131 Rome, Italy
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10
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Lai KKH, Wong TS, Li CK, Kuk A, Ko CKL. Solitary fibrous tumor of the lacrimal sac: A case report and review of the literature. J Fr Ophtalmol 2023; 46:e21-e24. [PMID: 36496292 DOI: 10.1016/j.jfo.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/20/2022] [Indexed: 12/12/2022]
Affiliation(s)
- K K H Lai
- Department of Ophthalmology, Tung Wah Eastern Hospital, 19, Eastern Hospital Road, Causeway Bay, Hong Kong.
| | - T S Wong
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, 3, Lok Man Road, Chai Wan, Hong Kong
| | - C K Li
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3, Lok Man Road, Chai Wan, Hong Kong
| | - A Kuk
- Department of Ophthalmology, Tung Wah Eastern Hospital, 19, Eastern Hospital Road, Causeway Bay, Hong Kong
| | - C K L Ko
- Department of Ophthalmology, Tung Wah Eastern Hospital, 19, Eastern Hospital Road, Causeway Bay, Hong Kong
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11
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Gao XJ, Peng XL, Wang YJ, He WM. Orbital solitary fibrous tumours: clinicopathological characteristics and recurrence prediction. Graefes Arch Clin Exp Ophthalmol 2023; 261:223-231. [PMID: 36029306 DOI: 10.1007/s00417-022-05795-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/14/2022] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND SFTs are thought to have an unpredictable clinical course and currently have no recognized prognostic criterion. Our study aimed to determine the relationship between clinicopathological characteristics and the prognosis of patients with orbital SFTs. METHODS The clinicopathological features of these patients were extracted from clinical records. The relationships between these features and prognosis were analysed. RESULTS The positive rates of CD34, CD99, Blc2, and STAT6 expression were 90.3%, 90.3%, 83.9%, and 100%, respectively. The tumour recurrence rate was 38.7%. A higher recurrence rate was observed in patients with Ki67 index ≥ 5 (56.25% vs. 20%, P = 0.038). CONCLUSION A Ki67 index ≥ 5 was an effective parameter for predicting tumour recurrence of orbital SFTs. Close follow-up is needed for these patients.
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Affiliation(s)
- Xiao-Jin Gao
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China.,Department of Ophthalmology, Chengdu First People's Hospital, Chengdu, China
| | - Xiao-Lin Peng
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu-Jiao Wang
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China
| | - Wei-Min He
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China.
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12
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Boschetti CE, Vitagliano R, Imola G, Cornacchini N, Colella ML, Tartaro G, Colella G. Solitary Extrapleural Fibrous Tumor in Salivary Glands: Our Experience-Case Series and Literature Review. Diagnostics (Basel) 2022; 12:2688. [PMID: 36359531 PMCID: PMC9688987 DOI: 10.3390/diagnostics12112688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/22/2022] [Accepted: 11/02/2022] [Indexed: 09/22/2023] Open
Abstract
(1) Background: Extrapleural solitary fibrous tumors (ESFTs) are rare oncological entities occurring in the head and neck, and even more so in the salivary glands. The clinical presentation and histologic features are usually unspecific, resulting in frequent misclassification. As an unusual tumor, ESTFs have an unpredictable clinical behavior. (2) Methods: We present two clinical cases referred to our Maxillofacial Surgery Unit for the onset of a symptomless mass involving, in one case, the parotid gland, and in the other case, the sublingual gland. (3) Results: Solitary fibrous tumors could be considered as neoplasms with intermediate biological behavior that are not entirely predictable on the basis of morphological features, as these are mostly still unknown. However, a few histologic, immunohistochemical, and imaging features, such as a hypodense signal at the T1 sequence in an MRI, or positivity for CD34, bcl2, and CD99, and the NAB2-STATS6 fusion gene, could be useful for an early differential diagnosis of ESTFs. (4) Conclusions: All patients were alive at follow-up with no evidence of disease. Surgical management should always be considered as the first choice for oncological radicality, and clinical behavior should always be defined with the help of the study of radiological and anatomopathological features.
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Affiliation(s)
| | - Rita Vitagliano
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Special- 8 ties, University of Campania “Luigi Vanvitelli”, Via Luigi de Crecchio, 6, 80138 Naples, Italy
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13
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Ozaniak A, Hladik P, Lischke R, Strizova Z. Diagnostic challenges and treatment options in patients with solitary fibrous tumor: A single-center observational study. Front Surg 2022; 9:952463. [PMID: 36277294 PMCID: PMC9583656 DOI: 10.3389/fsurg.2022.952463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/27/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Solitary fibrous tumor (SFT) is an extremely rare disease with a high misdiagnosis rate and a potentially malignant biologic nature. We have collected and analyzed data from 18 SFT patients to provide a deeper insight into this uncommon disease entity. Methods In our study, 18 patients who had undergone surgery between April 2014 and December 2021 for the diagnosis of SFT were evaluated. The collected data for each patient included the location of the SFT, the preoperative diagnosis, the definitive histological diagnosis, the presence of postoperative complications, the time of recurrence, the time of systemic progression, the type of treatment, and the survival rate. The median follow-up was 36 months. Results In three patients, the preoperative diagnosis did not correlate with the definitive histology of SFT. In patients with the limb location of SFT, no signs of recurrence nor distant metastases were seen within the study period. In total, 50% of the postsurgical complications were associated with the abdominal location of the SFT. In newly diagnosed SFT patients, two patients (20%) developed local recurrence, and the median time until recurrence was 22.5 months. Out of patients that were admitted and operated on for recurrent SFT, 67% relapsed, and the median time to relapse was 9.5 months. The systemic progression of the disease was observed in 33% of patients treated for recurrent SFT. Conclusion In our study, the misdiagnosis rate was high and correlated with previously published studies. Postsurgical complications were associated with the extrathoracic location of SFT. The mainstay of SFT treatment remains radical surgery, although radiotherapy alone can significantly improve overall survival. Clinical trials are urgently needed to evaluate the potential effect of other treatment modalities, such as immunotherapy and targeted therapy, in SFT patients.
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Affiliation(s)
- Andrej Ozaniak
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Pavel Hladik
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Robert Lischke
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Zuzana Strizova
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic,Correspondence: Zuzana Strizova
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14
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Fain K, Parmar K, Sharma M, Horn R, Sethi P. An unusual location of solitary fibrous tumor in heart-A case report and review of literature. Cancer Rep (Hoboken) 2022; 5:e1698. [PMID: 36041816 PMCID: PMC9675364 DOI: 10.1002/cnr2.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/04/2022] [Accepted: 07/27/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Solitary fibrous tumor (SFT) are rare spindle cell tumors originating from the mesenchymal cells mostly from the visceral pleura. SFT was first described as a distinct entity in 1931 by Klemperer et al. Until now, we have limited data regarding the manifestation and behavior of extra pleural forms such as cardiac SFT. Here we present a case of SFT involving the pericardium where the diagnosis was made by imaging followed by biopsy findings. We also review the literature of SFT involving the heart and the management approaches. CASE PRESENTATION An 81-year-old male presented with progressive dyspnea. Computed tomography (CT) of the chest showed a 6.2 × 5.3 cm soft tissue mass in the anterior mediastinum. Further imaging with CT angiogram showed a stalk-like connection to the pericardium. A biopsy of the mass showed spindle cells positive for BCL-2, CD34, and STAT 6, indicative of a solitary fibrous tumor. A surveillance approach was adopted for the patient. CONCLUSION Primary pericardial tumors are exceedingly rare, with a prevalence rate of 0.001%-0.007%. Diagnosing a SFT requires a positive CD34 and BCL-2 marker. The current recommendation is resection of localized disease which has been documented to be curative in cases of benign disease however our patient was put on surveillance.
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Affiliation(s)
- Kristen Fain
- School of MedicineTexas Tech University Health Science CenterLubbockTexasUSA
| | - Kanak Parmar
- Department of Internal MedicineTexas Tech University Health Science CenterLubbockTexasUSA
| | - Meenu Sharma
- Department of PathologyTexas Tech University Health Science CenterLubbockTexasUSA
| | - Robert Horn
- Department of Hematology‐OncologyTexas Tech University Health Science CenterLubbockTexasUSA
| | - Pooja Sethi
- Department of Cardiovascular MedicineTexas Tech University Health Science CenterLubbockTexasUSA
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15
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Bhati AS, Rana N, Raheja G, Tyagi SK. Rare Case of Solitary Nasal Fibrous Tumor Eroding Skull-Base. Asian J Neurosurg 2022; 17:375-378. [PMID: 36120639 PMCID: PMC9473812 DOI: 10.1055/s-0042-1750808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Solitary fibrous tumor (SFT) is a spindle cell lesion, classified under mesothelial tumors. Involvement of the nasal cavity, paranasal sinuses, and nasopharynx is rare. We present an extremely rare case of SFT of nasal origin eroding the anterior skull base. Complete local excision is the treatment of choice in the head and neck SFT, and we successfully excised the tumor by endoscopic approach only. The patient followed an uneventful course without any evidence of recurrence on 8-months follow-up.
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Affiliation(s)
| | - Nishant Rana
- ENT Department, Indraprastha Apollo Hospitals, New Delhi, India
| | - Girish Raheja
- ENT Department, Indraprastha Apollo Hospitals, New Delhi, India
| | - Sudheer K. Tyagi
- Department of Neurosurgery, Indraprastha Apollo Hospitals, New Delhi, India
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16
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Collins K, Warmke LM, Chen S, Ulbright TM. Angiomyofibroblastoma and Potential Mimicking Soft Tissue Tumors That May Occasionally Present in the Retroperitoneum: An Approach to the Differential Diagnosis With Report of an Unusual Index Case Abutting the Kidney. Adv Anat Pathol 2022; 29:141-153. [PMID: 35275847 DOI: 10.1097/pap.0000000000000336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The retroperitoneal soft tissues, extending from the pelvic floor to the level of the diaphragm, are the source of a variety of mesenchymal neoplasms with overlapping features and distinct clinical behaviors, making their distinction of crucial importance. Herein, we report a rare retroperitoneal angiomyofibroblastoma (AMFB) that presented as a right abdominal mass in a 25-year-old woman and that clinically simulated a primary renal carcinoma. The patient underwent complete surgical resection showing a well-circumscribed tumor adjacent to but separate from the right kidney. It was comprised of irregular, often anastomosing islands and cords of plump to spindled cells in a collagenous stroma with numerous thin-walled vessels. The tumor cells clustered around the vessels and admixed with moderate numbers of adipocytes. There was neither significant nuclear atypia nor mitotic activity. Immunohistochemically, the tumor cells showed strong reactivity for desmin, diffuse expression of estrogen and progesterone receptors, retained nuclear expression of retinoblastoma protein, and absent CD34 expression. The immunomorphological features were these of a "lipomatous variant" of AMFB of the retroperitoneum. The occurrence of AMFB in the retroperitoneum is unexpected since it mostly develops in the lower genital tract of young women, making its recognition in this rare location difficult. As a consequence, more common pelvic or retroperitoneal soft tissue neoplasms may represent the primary diagnostic considerations. We, therefore, review a variety of soft tissue tumors occurring in the pelvis/retroperitoneum that, to some degree, may mimic AMFB, and present key findings to assist in accurate diagnosis.
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Affiliation(s)
- Katrina Collins
- Department of Pathology, Indiana University School of Medicine, Indianapolis, IN
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17
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Lea M, Hofmann BM. Dediagnosing - a novel framework for making people less ill. Eur J Intern Med 2022; 95:17-23. [PMID: 34417089 DOI: 10.1016/j.ejim.2021.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 01/06/2023]
Abstract
Diagnosing constitutes a substantial part of healthcare work and triggers a wide range of actions including the prescription of medicines. Dediagnosing is proposed as a novel framework for removing diagnoses that do not contribute to the reduction of persons' suffering and should be introduced to make people less ill. Dediagnosing comes together with other efforts to reduce overuse, such as deimplementation, deprescribing, decommissioning, and disinvestment. Because diagnoses may influence identity construction and social rights, dediagnosing must be conducted in close collaboration with the patient.
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Affiliation(s)
- Marianne Lea
- Department of Pharmacy, Section for Pharmacology and Pharmaceutical Biosciences, University of Oslo, Oslo, Norway; Oslo Hospital Pharmacy, Hospital Pharmacies Enterprise, South Eastern Norway, Norway.
| | - Bjørn Morten Hofmann
- Department for the Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway; Centre of Medical Ethics, University of Oslo, PO Box 1130, Blindern, N-0318 Oslo, Norway
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18
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Yamada CAF, Narvaez EDO, Yamaki VN, Pfann RZ, Neville IS, Amaral LLFD. Cervical solitary fibrous tumor: case report and literature review. BJR Case Rep 2021; 7:20210058. [PMID: 35300229 PMCID: PMC8906161 DOI: 10.1259/bjrcr.20210058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are rare neoplasms in the spinal canal. There are few studies addressing SFT/hemangiopericytomas with no distinctive clinical characteristics, no conclusive radiological findings or even a well-defined best treatment strategy. We described a rare case of cervical SFT/hemangiopericytomas in a young patient with spinal cord compression. There are many differential diagnoses for spinal dural-based masses of which meningiomas are the most common. Surgeons and oncologists should be aware of differentials of dural-based masses in the spinal cord for surgical decision making and to guide treatment.
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Affiliation(s)
- Camilla Akemi Felizardo Yamada
- Departament of Oncology, Hospital BP, São Paulo, Brazil
- Latin American Cooperative Oncology Group - LACOG, Sao Paulo, Brazil
| | | | - Vitor Nagai Yamaki
- Department of Neurosurgery, Universidade de São Paulo, São Paulo, Brazil
| | | | - Iuri Santana Neville
- Department of Neurosurgery, Universidade de São Paulo, São Paulo, Brazil
- Instituto do Cancer do Estado de São Paulo – Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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19
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Zhang J, Liu J, Zhang Z, Tian B. Solitary Fibrous Tumors of the Chest: An Analysis of Fifty Patients. Front Oncol 2021; 11:697156. [PMID: 34277442 PMCID: PMC8280784 DOI: 10.3389/fonc.2021.697156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background A solitary fibrous tumor of the chest (SFTC) is a subtype of solitary fibrous tumor (SFT) with a low incidence rate. The purpose of this study is to analyze the diagnosis and treatment of SFTC and the difference between benign and malignant solitary fibrous tumor of the pleura (SFTP) to improve the understanding of this rare disease. Methods A retrospective analysis of fifty patients with SFTC (33 cases in the pleura and 17 in the lung) was performed. Clinical and imaging characteristics, pathological features, and treatment follow-up outcomes were analyzed. Results The common symptoms of the 50 patients included a cough, expectoration, chest tightness, fever, and chest pain. Space occupying lesions were found via plain computed tomography (CT) and enhanced CT was used for enhancement of the tumors. It was also found that 18 cases had necrosis, and 5 cases had calcification. The histopathology results showed that frequent nuclear division, obvious morphological variation, necrosis, and the high expression of Ki-67 cells are markers of malignant SFTC. There were significant differences in age, chest tightness, necrotic foci in CT, and expression of Ki-67 between the benign and malignant SFTP cases. All the patients who received treatment were given an excellent prognosis. Conclusion A combination of enhanced CT, histopathology, and immunohistochemistry can be used for the accurate diagnosis of SFTC. Advanced age, chest tightness, necrotic foci in CT, and a high Ki-67 index were more likely to be malignant SFTP. Operation and radiofrequency ablation can provide favorable outcomes for both benign and malignant SFTC.
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Affiliation(s)
- Jingwen Zhang
- Department of Geriatric Respiratory and Sleep, Henan Institute of Respiratory Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jumin Liu
- Department of Geriatric Respiratory and Sleep, Henan Institute of Respiratory Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhihao Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Beizong Tian
- Department of Geriatric Respiratory and Sleep, Henan Institute of Respiratory Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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20
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Sun Q, Choi YD, Kim Y. Cellular solitary fibrous tumor in the mental area: a case report and literature review. J Int Med Res 2021; 49:3000605211000536. [PMID: 33752509 PMCID: PMC7995497 DOI: 10.1177/03000605211000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are rare benign mesenchymal tumors that occur mainly in the pleura. We herein report the first case of a cellular SFT located in the mental region of the head and neck in a 46-year-old woman. Facial computed tomography revealed a mass measuring 0.8 cm with clear boundaries in the right mental region. After excision of the mass, expert pathologists diagnosed a cellular SFT. To our knowledge, this is the first case of a cellular SFT identified in the subcutaneous tissue of the mental region of the head and neck. Because the postsurgical prognosis of SFTs is unpredictable, long-term follow-up and further studies are necessary to determine the characteristics of cellular SFTs in the head and neck region.
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Affiliation(s)
- Qiaochu Sun
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea.,Current affiliation: Dalian Medical University, School of Stomatology, Dalian, Liaoning, China
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Young Kim
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
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21
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Woodard GA, Fels Elliott DR, Yap A, Haro GJ, Kratz JR, Mann MJ, Jones KD, Jablons DM. Resectability, Recurrence, and Risk Stratification of Giant Solitary Fibrous Tumors in the Thoracic Cavity. Ann Surg Oncol 2021; 28:4953-4959. [PMID: 33728541 DOI: 10.1245/s10434-021-09757-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/05/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Solitary fibrous tumors (SFTs) are rare mesenchymal tumors most commonly arising from the pleura in the thoracic cavity. The impact of tumor size on risk of recurrence in thoracic SFTs is not well understood. METHODS A single institution review was performed on all resected thoracic SFTs (1992-2019) with giant SFT defined as ≥ 15 cm. Clinical information, pathologic characteristics, and long-term survival data were collected, and predictors of recurrence and survival were evaluated with regression and Kaplan-Meier analysis. RESULTS There were 38 thoracic SFTs resected from patients, with the majority of tumors (n = 23, 60.5%) originating from visceral pleura. There were nine (23.7%) giant SFTs with a mean size 20.4 cm (range 17-30 cm). Mean follow-up time was 81.0 months (range 1-261 months), during which 4 of 38 (10.5%) patients experienced a recurrence within the thorax (range 51-178 months). The presence of tumor necrosis (p = 0.021) and ≥ 4 mitoses per high-powered field (p = 0.010) were associated with SFT recurrence on univariate regression. Overall 5-year, 10-year, and 20-year survival was 78.2%, 72.6%, and 42.4%, respectively, and SFT-related mortality occurred in three patients at 83, 180, and 208 months postoperatively. There were no recurrences or SFT-related mortality among patients with giant SFT. CONCLUSION This study represents one of the largest contemporary single institution reviews of long-term outcomes of giant thoracic SFT. Our data suggest that size is not a risk factor for recurrence in thoracic SFTs and long-term survival is excellent for giant SFTs.
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Affiliation(s)
- Gavitt A Woodard
- Department of Surgery, Section of Thoracic Surgery, Yale School of Medicine, New Haven, CT, USA.
| | | | - Ava Yap
- Department of Surgery, Section of Thoracic Surgery, University of California, San Francisco, USA
| | - Greg J Haro
- Department of Surgery, Section of Thoracic Surgery, University of California, San Francisco, USA
| | - Johannes R Kratz
- Department of Surgery, Section of Thoracic Surgery, University of California, San Francisco, USA
| | - Michael J Mann
- Department of Surgery, Section of Thoracic Surgery, University of California, San Francisco, USA
| | - Kirk D Jones
- Department of Pathology, University of California, San Francisco, USA
| | - David M Jablons
- Department of Surgery, Section of Thoracic Surgery, University of California, San Francisco, USA
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22
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Rodrigues MFSD, Tobouti PL, Molon AC, Sedassari BT, Nunes FD, Pinto DDS, de Sousa SCOM. Histopathological findings and immunohistochemical expression of the stem cell markers CD44, ALDH1, Bmi-1, and Nanog in oral solitary fibrous tumors. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:444-451. [PMID: 33610537 DOI: 10.1016/j.oooo.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/25/2020] [Accepted: 11/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the histomorphologic presentation and the expression of stem cell-related markers in a series of oral solitary fibrous tumors (SFTs). STUDY DESIGN Histopathological variables and the expression of the standard stem cell markers CD34 and CD99, used for SFT diagnosis, as well as STAT6 were evaluated in 13 oral SFTs. The expression of the cancer stem cell markers CD44, ALDH1, Bmi-1, and Nanog and the tumor suppressor gene p16Ink4a were also investigated. RESULTS The majority of oral SFTs were circumscribed and characterized by a proliferation of spindle cells arranged in a hyalinized stroma. Only 2 oral SFTs showed >4 mitoses/10 high-power fields. Hypercellularity as well as nuclear and cellular pleomorphism were classified as low and moderate in most of the oral SFTs. All oral SFTs were positive for CD34, STAT6, CD44, ALDH1, Bmi-1, and p16Ink4a. CD99 and Nanog expression was observed in 11 and 10 oral SFT cases, respectively. CONCLUSION We suggest that STAT6 and ALDH1 have relevant diagnostic value. The expression of CD44, ALDH1, Bmi-1, and Nanog, which is observed in cancer stem cells, may confer advantages to oral SFT cells.
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Affiliation(s)
| | | | - Angela Cristina Molon
- Biophotonics Applied to Health Science, Nove de Julho University, São Paulo, Brazil.
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23
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Li YN, Li CL, Liu ZH. Dumbbell-shaped solitary fibrous tumor in the parapharyngeal space: A case report. World J Clin Cases 2021; 9:1204-1209. [PMID: 33644185 PMCID: PMC7896643 DOI: 10.12998/wjcc.v9.i5.1204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/03/2020] [Accepted: 12/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFTs) occurring in the parapharyngeal space are rare, and their final diagnosis depends on pathological and immunohistochemical analyses. Once the tumor is diagnosed, complete resection and regular postoperative follow-up are required.
CASE SUMMARY A 40-year-old male patient with a right parotid gland mass discovered 8 years ago was admitted to hospital. The mass showed no tenderness or local skin redness. Imaging was carried out as the patient had stable vital signs and showed that the mass was a dumbbell-shaped tumor comprising a superficial tumor approximately 5 cm long and 3 cm wide in size that compressed the right parotid gland and a deep tumor located in the right parapharyngeal space approximately 4.5 cm long and 2.5 cm wide in size. Both tumors were connected in the middle. Prior to surgery, the tumors were considered to be parapharyngeal schwannomas. During surgical dissection, the tumors were found to be smooth and tough, without obvious adhesion to the surrounding tissues. The tumors were revealed to be a SFT following postoperative pathological analysis.
CONCLUSION SFTs in the parapharyngeal space are rarely reported, and complete resection of such tumor is recommended. Adjuvant chemoradiotherapy is used in patients with extensive tumor invasion to lower the recurrence rate. Postoperative long-term follow-up is required.
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Affiliation(s)
- Yu-Nuo Li
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Chun-Lei Li
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Zhao-Hui Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
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24
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Shmuly T, Ben Zvi Y, Chaushu G, Kaplan I. Oral Solitary Fibrous Tumor: A Retrospective Clinico-Pathological Study and Long-Term Follow-Up. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:152. [PMID: 33567630 PMCID: PMC7914433 DOI: 10.3390/medicina57020152] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 12/16/2022]
Abstract
Background and Objectives: This was a retrospective single-center study to analyze and describe the clinical and histological features of all cases of oral solitary fibrous tumor (SFT). Study design: the study included all consecutive cases of oral SFT diagnosed between 2008-2018 at a single tertiary center. Materials and Methods: Clinical data was retrieved from medical charts. The diagnosis of oral SFT was based upon the morphologic features of the lesions, in routine hematoxylin and eosin (H&E) stained sections and confirmed by immunohistochemical analyses including CD34, CD99, Bcl2, and stains for STAT6. Results: Seven cases of oral SFT were found. Of these, three (42%) were in males and four (58%) in females. The age range was 24-63 years (mean 47 ± 13). Four (58%) lesions were located in the buccal mucosa, two (28%) in the labial mucosa and one (14%) on the floor of the mouth. The diameter ranged between 3-50 mm (mean 22 ± 14 mm). All patients were treated with local excision. Follow-up periods were between 2-74 months (mean 41 ± 27). No recurrences were reported. Conclusions: We present a series of oral SFT, which were all non-aggressive in presentation and did not recur after conservative surgery (local excision) over a relatively long follow-up period.
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Affiliation(s)
- Tom Shmuly
- Oral and Maxillofacial Surgery Department, Kaplan Medical Center, Rehovot 7642001, Israel
- Oral and Maxillofacial Surgery Department, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel;
| | - Yehonatan Ben Zvi
- Oral and Maxillofacial Surgery Department, Rabin Medical Center, Petah-Tikva 4941492, Israel;
| | - Gabriel Chaushu
- Oral and Maxillofacial Surgery Department, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel;
- Oral and Maxillofacial Surgery Department, Rabin Medical Center, Petah-Tikva 4941492, Israel;
| | - Ilana Kaplan
- Pathology Department, Rabin Medical Center, Petah-Tikva 4941492, Israel;
- Oral Pathology Department, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel
- Pathology Department, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel
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25
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Gonzalez JA, Sanchez E, Messa Botero O, Cervera-Bonilla S. Solitary Fibrous Tumor in the Perianal Region: Report of Two Cases With an Atypical Location. Cureus 2021; 13:e12887. [PMID: 33643733 PMCID: PMC7901715 DOI: 10.7759/cureus.12887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A solitary fibrous tumor (SFT) is a mesenchymal neoplasm of spindle cells, initially described in the pleura. The World Health Organization (WHO) classifies the solitary fibrous tumor as a neoplasm with intermediate biological potential. Diagnostic images are essential for the diagnostic and therapeutic approach in this entity. The standard of treatment for this type of lesion is surgical resection with oncological margins larger than 1 cm. The solitary fibrous tumors located in the perianal, perineal, and pelvic regions are infrequent and represent a challenge in the clinical approach, mainly because the manifestations are nonspecific. Given the low incidence of this type of neoplasm, we present two cases of SFT in the perianal region managed in a high-complexity hospital.
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Affiliation(s)
| | - Elio Sanchez
- Surgical Oncology, Instituto Nacional de Cancerología, Bogota, COL
| | | | - Sergio Cervera-Bonilla
- Breast and Soft Tissue Surgery, Hospital Universitario San Ignacio, Bogota, COL.,Breast and Soft Tissue Surgery, Instituto Nacional de Cancerología, Bogota, COL
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Hasegawa O, Watanabe M, Kono M, Yunaiyama D, Chikazu D. Preoperative transarterial embolization for solitary fibrous tumor of the tongue: A case report. Mol Clin Oncol 2021; 14:55. [PMID: 33604045 PMCID: PMC7849066 DOI: 10.3892/mco.2021.2217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/27/2020] [Indexed: 11/06/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are derived from mesenchymal cells originating mainly from the pleura. Reports of bleeding SFTs in head and neck regions are rare. A number of reports have focused on tongue SFT treatments, but to the best of our knowledge, there are no reports on the usefulness of preoperative arterial embolization. Intraoperative and postoperative bleeding can also lead to airway problems. To avoid unnecessary tracheostomy and ligation of the external carotid artery, preoperative vascular embolism should be considered while removing large tumors or tumors with high blood flow. The current report outlines a case of a 32-year-old woman with a tongue solitary fibrous tumor, who underwent right lingual artery embolization with 300-500 and 500-700 µm embosphere microspheres through a vascular catheter the day before surgical resection. The encapsulated tumor was completely excised under general anesthesia with little to no bleeding during the operation.
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Affiliation(s)
- On Hasegawa
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Masato Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Michihide Kono
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Daisuke Yunaiyama
- Department of Radiology, Tokyo Medical University, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Daichi Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Shinjyuku-ku, Tokyo 160-0023, Japan
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Tran V, Slavin J. Soft Tissue Tumour Pathology. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Broggi G, Salvatorelli L, Reibaldi M, Bonfiglio V, Longo A, Russo A, Caltabiano R, Magro G. Solitary fibrous tumor of the orbital region: report of a case with emphasis on the diagnostic utility of STAT-6. Pathologica 2020; 112:195-199. [PMID: 33393522 PMCID: PMC8183349 DOI: 10.32074/1591-951x-9-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023] Open
Abstract
Solitary fibrous tumor (SFT) is a relatively rare soft tissue neoplasm originally described in the pleura. Since its first description, several cases arising in extra-pleural superficial and deep soft tissues have been reported in the literature. SFT arising in the head and neck region is quite rare, representing about the 6% of all SFTs, and the sinonasal tract is the most common involved region, followed by the orbit, the oral cavity and the salivary glands. Herein, we report the clinico-pathologic features of a rare case of SFT of the orbital region, emphasizing the diagnostic role of the immunomarker STAT-6. A 52-year-old female presented to our hospital with a nodular mass in the left orbital region. Histological examination revealed a uniformly hypercellular tumor composed of pale to slightly eosinophilic bland-looking spindle cells arranged in intersecting short fascicles with interspersed stellate-shaped, keloid-type collagen fibers. Notable hypocellular areas, perivascular hyalinization and hemangiopericytoma-like branching vascular pattern were absent. Immunohistochemically, neoplastic cells were diffusely positive for vimentin, CD34 and STAT-6. The introduction of STAT-6 in daily diagnostic practice is helpful to confidentially render a diagnosis of SFT even in the presence of unusual morphology and site.
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Affiliation(s)
- Giuseppe Broggi
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | - Lucia Salvatorelli
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | | | | | - Antonio Longo
- Department of Ophthalmology, University of Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Italy
| | - Rosario Caltabiano
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | - Gaetano Magro
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
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Afzal A, Maldonado-Vital M, Khan S, Farooque U, Luo W. Solitary Fibrous Tumor of Pancreas With Unusual Features: A Case Report. Cureus 2020; 12:e10833. [PMID: 33173639 PMCID: PMC7647364 DOI: 10.7759/cureus.10833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Solitary fibrous tumor (SFT) is an uncommon fibroblastic neoplasm that is most commonly associated with the pleura but has also been reported in almost all anatomic sites. Although the majority of SFTs are benign, few cases follow a malignant clinical course and may recur and/or metastasize after several years of their original occurrence. Only 16 cases of pancreatic SFTs are reported so far, and only one has metastasized to lung and subcutis. Pancreatic SFT resembles more common neuroendocrine tumor and gastrointestinal stromal tumor (GIST) radiographically and is at times almost indistinguishable from GIST histologically. Diagnosis of SFTs particularly, if attempted on biopsied specimens, can be very challenging due to its rare occurrence and nondescript morphology. It is imperative to understand the pathological spectrum of this entity to avoid misdiagnosis. We report a case of pancreatic SFT in a 43-year-old male with some unusual morphologic and immunohistochemical features including pseudoangiomatous growth pattern, a hypercellular area demonstrating nuclear pleomorphism, and only focal positivity for cluster of differentiation (CD)34. These atypical features can pose even more diagnostic challenge by causing additional confusion with other malignancies like dedifferentiated liposarcoma and vascular tumors. The potential diagnostic pitfalls are discussed.
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Affiliation(s)
- Anoshia Afzal
- Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | | | - Shahbaz Khan
- Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Umar Farooque
- Neurology, Dow University of Health Sciences, Karachi, PAK
| | - Wenyi Luo
- Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, USA
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Abstract
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms of fibroblastic origin. They commonly arise from visceral pleura, but also arise from nonserosal sites such as meninges, central nervous system parenchyma, and spinal cord. In the spinal cord, SFTs commonly arise from the thoracic spinal cord, followed by cervical spinal cord, lumbar spinal cord, and sacrum. Histologically, SFTs can be similar to hemangiopericytoma, schwannoma, fibrous meningioma, fibroma, gliofibroma, and ependymoma. Immunohistochemistry (IHC) plays an important role in differentiating SFTs from other identical tumors. Here, we report a rare case of SFT of the cervical spinal cord, which was initially reported as hemangiopericytoma, and the diagnosis of SFT was confirmed by IHC.
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Affiliation(s)
- Mallikarjuna Rao Koduru
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Sandeep Ail
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Jayarama Shetty
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Vijith Shetty
- Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
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de Morais EF, Martins HDD, Rodrigues KS, de França GM, da Silveira ÉJD, Freitas RDA. Clinicopathologic Analysis of Oral and Maxillofacial Solitary Fibrous Tumor. Am J Clin Pathol 2020; 154:15-22. [PMID: 32134474 DOI: 10.1093/ajcp/aqaa027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The aim of this systematic review was to provide an overview of the oral and maxillofacial solitary fibrous tumor (SFT) in order to determine its clinicopathologic characteristics and biological behavior. METHODS We conducted a systematic review in May 2019 in multiple databases. Cases diagnosed as SFT in the oral cavity and maxillofacial complex were included. RESULTS Seventy-three published articles were included in our systematic review, corresponding to a total of 154 cases. SFT showed a slight female predilection (53.2%), and the cheek mucosa/cheek, tongue, and palate were the most affected anatomical sites. The mean size of SFT in the oral cavity and maxillofacial region at diagnosis was 1.4 cm. Histologic features of malignancy by morphologic analysis (P < .001) were significantly associated with a larger tumor size. Surgical excision was the most frequent therapeutic modality. Recurrence and metastasis were uncommon findings in our sample. CONCLUSIONS Histologic features of malignancy can be important parameters of tumor behavior. Adequate surgical treatment and long-term follow-up are required for these cases.
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Clinical Presentation, Natural History, and Therapeutic Approach in Patients with Solitary Fibrous Tumor: A Retrospective Analysis. Sarcoma 2020; 2020:1385978. [PMID: 32300277 PMCID: PMC7140119 DOI: 10.1155/2020/1385978] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/20/2020] [Accepted: 03/02/2020] [Indexed: 12/16/2022] Open
Abstract
Background Solitary fibrous tumor (SFT) is a rare variant of soft tissue sarcoma (STS). Materials and Methods. We reviewed SFT patients (pts) treated at our institution between 12/1990 and 09/2017. Results We identified 94 pts with a median follow-up (mFU) of 4.7 years (range: 0.1–21.53). Primary sites were the chest (33%), abdomen (21.3%), brain (12.8%), and extremities (9.6%); 6.4% of pts presented with synchronous metastasis. Median overall survival (mOS) from the first diagnosis was 56.0 months (m) (0.3–258.3). Doege–Potter syndrome was seen in 2.1% of pts. Primary resection was performed in 86 pts (91.5%). Median progression-free survival was 34.1 m (1.0–157.1), and 43% of pts stayed SFT-free during FU. Local recurrence occurred in 26.7% after a mFU of 35.5 m (1.0–153.8), associated with an OS of 45.1 m (4.7–118.2). Metachronous metastasis occurred in 30.2% after a mFU of 36.0 m (0.1–157.1). OS in metastatic pts was 19.0 m (0.3–149.0). Systemic therapy was given to 26 pts (27.7%) with inoperable/metastatic disease. The most common (57.7%) upfront therapy was doxorubicin, achieving responses in 13.3% of pts with a PFS of 4.8 m (0.4–23.8). In second line, pts were treated with ifosfamide or pazopanib, the latter achieving the highest response rates. Third-line treatment was heterogeneous. Conclusion SFT is an orphan malignancy with a highly variable clinical course and a considerable risk of local failure and metachronous metastasis. Surgery is the only curative option; palliative systemic therapy is used in inoperable/metastatic cases but achieves low response rates. The highest response rates are seen with pazopanib in second/third line.
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Solitary fibrous tumors of the head and neck region revisited: a single-institution study of 20 cases and review of the literature. Hum Pathol 2020; 99:1-12. [PMID: 32217090 DOI: 10.1016/j.humpath.2020.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/07/2020] [Accepted: 03/16/2020] [Indexed: 01/18/2023]
Abstract
A solitary fibrous tumor (SFT) is a rare, NAB2-STAT6 fusion gene-associated mesenchymal neoplasm. It most commonly arises in the pleural site, but it can occur at many other sites, and rarely also in the head and neck (H&N) region. STFs may show many growth patterns and therefore can be easily mistaken for other more common H&N spindle cell or epithelial lesions. In this study, we present our experience in the diagnosis of 20 cases of SFT in the H&N region and discuss their most notable mimickers. In all cases, STAT6 expression was found positive by immunohistochemistry, and the NAB2-STAT6 fusion was confirmed by next-generation sequencing. Three major fusion variants were detected: NAB2ex2-STAT6int1 (5/20, 25%), NAB2ex6-STAT6ex16 (4/20, 20%), and NAB2ex4-STAT6ex2 (3/20, 15%). Clinical follow-up was available for 16 patients (median follow-up time: 84 months). One patient with a morphologically malignant SFT experienced multiple local recurrences, followed by dissemination into the lungs and meninges. This malignant SFT also displayed an aberrant FLI1 expression, which was not previously reported in SFT cases. We also summarize findings from 200 cases of SFT of the H&N region, which included cases from our study, and from previous studies that reported on the fusion status of the STAT6 gene. The results suggest that metastatic disease developed only in cases with STAT6 variants that included the DNA-binding domain (STAT6-full variants), which contradicts expectations from previous reports and deserves further investigation.
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Glauser G, Sharma N, Kritikos M, Malhotra NR, Choudhri O. Cervical, Intradural Extramedullary Solitary Fibrous Tumor of the Spinal Cord: A Case Report and Review of the Literature. Asian J Neurosurg 2020; 15:204-209. [PMID: 32181204 PMCID: PMC7057895 DOI: 10.4103/ajns.ajns_213_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/25/2019] [Indexed: 12/18/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are rare, spindle cell neoplasms of the mesenchymal origin. Lesions localized to the spine are exceptionally uncommon, only described in the literature in case reports and small case series. While these lesions are typically benign, there are a few reports in which they recur or present as malignancies. The patient presented in the case herein was a 72-year-old male, who presented with a 1-year history of lower extremity weakness, pain, and numbness and was found to have a cervical, intradural extramedullary tumor. In addition to the case report, the authors perform a thorough review of all previously published cases of spinal SFT.
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Affiliation(s)
- Gregory Glauser
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil Sharma
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Kritikos
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil Rainer Malhotra
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Omar Choudhri
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Chang TH, Chen M, Lee CC. Solitary fibrous tumor of the scrotum: a case report and review of the literature. BMC Urol 2019; 19:138. [PMID: 31888599 PMCID: PMC6937639 DOI: 10.1186/s12894-019-0573-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/22/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Solitary fibrous tumor (SFT) is a rare soft tissue tumor originally reported in the pleura. Although it has been reported in various extra-pleural sites, the occurrence of SFT in the scrotum is extremely rare. Herein, we present a 48-year-old man who had scrotal SFT. There are very few reported cases of genitourinary SFTs, this is only the fifth report of SFT of the scrotum in the English medical literature. CASE PRESENTATION In this study, we report on a 48-year-old man who presented with a 5 × 8 cm scrotal mass between his testes. Physical examination revealed a 4.7 × 8.5 cm lobulated tumor mass located between his testicles. Surgical excision of the tumor with scrotal approach was done and pathology reported a SFT. The patient was alive without tumor recurrence or distant metastasis during ongoing follow-up for 9 months post-operatively.. CONCLUSION Scrotal SFTs are very rare and only five cases have been reported in English literature to date. Treatment often involves surgical resection, and a definite diagnosis is made with the help of immunohistochemistry. The current general consensus for the management of SFTs is long-term follow-up after surgical excision of the tumor.
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Affiliation(s)
- Tsung-Hsin Chang
- Department of Urology, Mackay Memorial hospital, No.92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist, 10449, Taipei City, Taiwan (Republic of China).,Mackay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi Dist, 252, New Taipei City, Taiwan (Republic of China)
| | - Marcelo Chen
- Department of Urology, Mackay Memorial hospital, No.92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist, 10449, Taipei City, Taiwan (Republic of China).,Mackay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi Dist, 252, New Taipei City, Taiwan (Republic of China)
| | - Chih-Chiao Lee
- Department of Urology, Mackay Memorial hospital, No.92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist, 10449, Taipei City, Taiwan (Republic of China). .,Mackay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi Dist, 252, New Taipei City, Taiwan (Republic of China).
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Mindiola‐Romero AE, Maloney N, Bridge JA, Korkolopoulou P, Sakellariou S, Linos K. A concise review of angiofibroma of soft tissue: A rare newly described entity that can be encountered by dermatopathologists. J Cutan Pathol 2019; 47:179-185. [DOI: 10.1111/cup.13580] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/05/2019] [Accepted: 09/13/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Andres E. Mindiola‐Romero
- Department of Pathology and Laboratory MedicineDartmouth‐Hitchcock Medical Center and Geisel School of Medicine at Dartmouth Lebanon New Hampshire
| | - Nolan Maloney
- Department of Pathology and Laboratory MedicineDartmouth‐Hitchcock Medical Center and Geisel School of Medicine at Dartmouth Lebanon New Hampshire
| | - Julia A. Bridge
- Division of Molecular Pathology, The Translational Genomics Research Institute, Phoenix, Arizona and Department of Pathology and MicrobiologyUniversity of Nebraska Medical Center Omaha Nebraska
| | | | | | - Konstantinos Linos
- Department of Pathology and Laboratory MedicineDartmouth‐Hitchcock Medical Center and Geisel School of Medicine at Dartmouth Lebanon New Hampshire
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Chaouch MA, Jerraya H, Dougaz MW, Haloui N, Bouasker I, Nouira R. A Case Report of a Right Mesocolon Solitary Fibrosis Tumour. J Gastrointest Cancer 2019; 51:351-353. [PMID: 31407250 DOI: 10.1007/s12029-019-00294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Hichem Jerraya
- Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Nabil Haloui
- Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Ramzi Nouira
- Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia
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Wang Y, Zhang J, Liu Q, Liu F, Zhu X, Zhang J. Solitary fibrous tumor of the pineal region with delayed ectopic intracranial metastasis: A case report and review of the literature. Medicine (Baltimore) 2019; 98:e15737. [PMID: 31124953 PMCID: PMC6571265 DOI: 10.1097/md.0000000000015737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
RATIONALE Solitary fibrous tumors of central nervous system are rare spindle-cell mesenchymal tumors. Although most are benign in nature, malignant transformation and extracranial metastasis have been reported. Up to now, only one case of CSF dissemination was described. Here we described an extremely rare case of intracranial Solitary fibrous tumors arising from the pineal region with a delayed ectopic metastasis. PATIENT CONCERNS A 35-year-old female presented with double vision, memory disturbance and unsteady gait was referred to our center. MRI showed an irregular mass in the pineal region. DIAGNOSES The patient was diagnosed as pineal tumor, with unknown pathology. INTERVENTIONS Gross total resection was achieved and the pathologic studies confirmed a solitary fibrous tumor. Thirty-nine months later local recurrence occurred and gamma-knife radiotherapy was offered. Seven months later, MRI found a metastasis in the left temporal lobe. Surgical resection was conducted and pathological analysis revealed changes in cell morphology, counts and Ki-67 level, confirmed the diagnosis of solitary fibrous tumor/hemangiopericytoma (WHO Grade III). The patient received post-operational radiotherapy. OUTCOMES The patient was followed up for 7 months with no signs of recurrence. LESSONS Here, we report an extremely rare case of primary solitary fibrous tumor of pineal region with delayed intracranial ectopic metastasis, together with literature review of metastatic solitary fibrous tumors. Strict surveillance is strongly recommended, considering the malignant potential of this seemingly benign disease entity. Complete resection of the tumor is the treatment of first choice and radiotherapy might be an effective adjuvant therapy for high grade SFT/HPCs.
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Shin K, Kim TW, Lee HJ, Park SM, Jin H, Shim WH, Kim GW, Kim HS, Ko HC, Kim BS, Kim MB, You HS. A Case of Malignant Solitary Fibrous Tumor of the Skin. Ann Dermatol 2019; 31:226-228. [PMID: 33911576 PMCID: PMC7992671 DOI: 10.5021/ad.2019.31.2.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kihyuk Shin
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Tae-Wook Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Hyun-Joo Lee
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sung-Min Park
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Hyunju Jin
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Woo-Haing Shim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Gun-Wook Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyang-Suk You
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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A Modern Reaffirmation of Surgery as the Optimal Treatment for Solitary Fibrous Tumors of the Pleura. Ann Thorac Surg 2019; 107:941-946. [DOI: 10.1016/j.athoracsur.2018.08.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/15/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022]
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Lv G, Wang K, Li M, Li Z, Zheng A, Pang Q. Recurrence of multiple metastases after surgical removal of a primary malignant solitary fibrous tumor from the main bronchus: A case report. Medicine (Baltimore) 2018; 97:e13560. [PMID: 30558017 PMCID: PMC6320158 DOI: 10.1097/md.0000000000013560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/14/2018] [Indexed: 12/31/2022] Open
Abstract
RATIONALE Limited knowledge is available regarding solitary fibrous tumors (SFTs), about 15% of which are malignant. In particular, the long-term survival of patients with malignant SFTs (mSFTs), the disease course, and the potential for recurrence of second primary tumors or distant metastases are largely undetermined. PATIENT CONCERNS We report a rare case in which an mSFT was found at the main bronchus of the right lung of a 37-year-old man. DIAGNOSIS The tumor cells of mSFT were spindle-shaped and expressed antigen Ki-67, B-cell lymphoma 2, cluster of differentiation 31, and vimentin. INTERVENTIONS A total pneumonectomy was performed. OUTCOMES The patient developed fibrosarcoma of the small intestine at 6 months, as well as extensive pleural and peritoneal metastases at 1 year, after removal of the primary mSFT from the right main bronchus. LESSONS From these findings, we expect that patients with primary mSFT, especially of the lung, have a high potential to develop second tumors or distant metastases. Close monitoring after surgery is necessary to improve the outcomes of these patients.
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Affiliation(s)
| | | | - Miao Li
- Department of Pathology, First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
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Davanzo B, Emerson RE, Lisy M, Koniaris LG, Kays JK. Solitary fibrous tumor. Transl Gastroenterol Hepatol 2018; 3:94. [PMID: 30603730 PMCID: PMC6286917 DOI: 10.21037/tgh.2018.11.02] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 01/03/2023] Open
Abstract
Solitary fibrous tumor (SFT) is a rare tumor of mesenchymal origin that account for less than 2% of all soft tissue masses. Initially identified in the pleura, SFT has been identified in multiple anatomic locations and can arise anywhere in the body. The varying histologic features along with non-specific means of identification have led SFT to be associated with several different names. Over the last several decades, sustained advances through research and technology have led to more reliable methods for differentiating this distinct soft tissue tumor. Advances specifically in immunohistochemistry and molecular diagnostics have identified CD34 as the most consistent marker in SFT, however even this lacks specificity to conclusively narrow down the broad differential for exact identification. More recently the discovery of the NAB2-STAT6 fusion gene has led to more precise diagnosis of SFT. Like many other soft tissue tumors, surgical management is the mainstay of treatment for SFT with emphasis on obtaining tumor-negative margins. Radiation therapy and chemotherapy regimens have not demonstrated global effectiveness, and thus no standardized treatments have been identified. Given the rarity of SFT and current supportive evidence for therapies, management should be focused on tumor extirpation. Nonetheless, individualized therapy, determined within a multidisciplinary setting should be considered.
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Affiliation(s)
- Brian Davanzo
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert E. Emerson
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Megan Lisy
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leonidas G. Koniaris
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Joshua K. Kays
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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Tan F, Wang Y, Gao S, Xue Q, Mu J, Mao Y, Gao Y, Zhao J, Wang D, Zhou L, He J. Solitary fibrous tumors of the pleura: A single center experience at National Cancer Center, China. Thorac Cancer 2018; 9:1763-1769. [PMID: 30414313 PMCID: PMC6275837 DOI: 10.1111/1759-7714.12909] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This study explored the clinicopathological features, predictive factors of malignancy, effectiveness of video assisted thoracic surgery (VATS), and prognosis of solitary fibrous tumor of the pleura (SFTP). METHODS A single-center retrospective study of the data of 82 patients with SFTP who were surgically treated in our department between January 2003 and December 2015 was conducted. RESULTS A total of 82 SFTPs (70 benign, 12 malignant) were included and all patients underwent complete en bloc resection. SFTPs originated from the visceral pleura in 47 (57%) and the parietal pleura in 35 (43%) patients. In our cohort, malignant tumors were often symptomatically large, and the patients with malignant SFTPs (mSFTPs) often had a family history of neoplasms. Patients in the VATS group (n = 22) had tumors with significantly smaller diameters, required a shorter surgical duration and shorter hospital stay, and experienced less intraoperative blood loss and less postoperative chest tube drainage compared to the thoracotomy group (n = 60). No tumor recurrence was found in benign SFTP (bSFTP) patients. The long term survival and disease-free survival rates of mSFTP patients were 76% and 53%, respectively. CONCLUSION Larger tumor diameter and a family history of neoplasm may be predictive factors for mSFTP; however, this conclusion needs to be verified in large cohort. VATS is safe and reliable for treating selected SFTP patients. Local recurrence is associated with mSFTP patient death, thus close follow-up of such patients is crucial.
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Affiliation(s)
- Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yalong Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Juwei Mu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shen Zhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yushun Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Zhao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dali Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lina Zhou
- Department of Diagnostic Radiotherapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Liu Y, Wang Q, Zhang T, Yang L, Liang WJ. MR imaging of intracranial solitary fibrous tumor: a retrospective study of 7 cases. Afr Health Sci 2018; 18:799-806. [PMID: 30603014 PMCID: PMC6306993 DOI: 10.4314/ahs.v18i3.39] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To investigate the MR imaging diagnostic features of intracranial solitary fibrous tumors (ISFTs). MATERIALS AND METHODS Seven patients (mean age of 52.9 years; M:F=3:4) with histopathologically proven ISFTs were identified at our institute. Clinical presentations and pathological features were reviewed. MR Imaging findings including signal intensity, gadopentetate dimeglumine enhanced pattern, and diffusion-weighted imaging (DWI) characterization of the tumors were retrospectively evaluated. RESULTS Six tumors showed a multi-lobular contour. Five tumors showed heterogeneous signal intensity, and two tumors showed homogeneous signal intensity on T1WI. Low signal intensity linear, curved or interlacing lines were observed within the tumors in all seven cases. Seven tumors demonstrated moderate or strong enhancement, six showed heterogeneous enhancement, and one homogenous enhancement. All tumors showed heterogeneous signal intensity on DWI.A ring-like high signal intensity band distributed around within the tumor was noted in six cases on DWI. CONCLUSION Diagnostic evidence for ISFT on MR image includes heterogeneous signal intensity, intense enhancement of T2 signal intensity, low signal intensity lines within the tumor, heterogeneous signal intensity on DWI and a ring-like band around the tumor on DWI.
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Affiliation(s)
- Yongshan Liu
- Department of Radiology, Qingdao Haici Medical Group, 4 Renmin Road, Shibei District, Qingdao, Shandong Province 266033 China
| | - Qian Wang
- Department of Radiology, Qingdao Haici Medical Group, 4 Renmin Road, Shibei District, Qingdao, Shandong Province 266033 China
| | - Taijuan Zhang
- Department of Radiology, Qingdao Haici Medical Group, 4 Renmin Road, Shibei District, Qingdao, Shandong Province 266033 China
| | - Linlin Yang
- Department of Radiology, Qingdao Haici Medical Group, 4 Renmin Road, Shibei District, Qingdao, Shandong Province 266033 China
| | - Wen Juan Liang
- Department of Radiology, Qingdao Haici Medical Group, 4 Renmin Road, Shibei District, Qingdao, Shandong Province 266033 China
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Cox J, Armstrong JE, Pandey S, Wehrli B, Chan KC, McCord C. Enlarging growth of the mental region in a 48-year-old man. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 128:191-198. [PMID: 30122440 DOI: 10.1016/j.oooo.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/18/2018] [Accepted: 07/02/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Jacqueline Cox
- Department of Dentistry, London Health Sciences Centre, London, Ontario, Canada; Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jerrold E Armstrong
- Department of Dentistry, London Health Sciences Centre, London, Ontario, Canada; Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sachin Pandey
- Department of Medical Imaging, London Health Sciences Centre and Western University, London, Ontario, Canada
| | - Bret Wehrli
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - King Chong Chan
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | - Christina McCord
- Department of Dentistry, London Health Sciences Centre, London, Ontario, Canada; Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada; Division of Oral pathology, Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
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Mori S, Lezcano C, Miraflor AP, Busam KJ, Lee EH. Solitary fibrous tumor presenting on the scalp: a potential diagnostic pitfall. J Cutan Pathol 2018; 45:557-560. [PMID: 30004148 PMCID: PMC6614870 DOI: 10.1111/cup.13272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 04/20/2018] [Accepted: 05/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Shoko Mori
- SUNY Downstate College of Medicine, Brooklyn, New York
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cecilia Lezcano
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Allen P. Miraflor
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Klaus J. Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Erica H. Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
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Abstract
The pleura may be affected by primary tumors or metastatic spread of intrathoracic or extrathoracic neoplasms. Primary pleural neoplasms represent ∼10% of all pleural tumors, and malignant lesions are more common than benign lesions. The most common primary tumors include malignant pleural mesothelioma and solitary fibrous tumor. Although pleural neoplasms may initially be evaluated with computed tomography (CT) and/or fluorodeoxyglucose positron emission tomography (PET)/CT, magnetic resonance (MR) imaging is complementary to these other imaging modalities for disease staging and evaluation of patients. In this article, we discuss the etiology, clinical presentation, and imaging of pleural neoplasms, with specific attention given to the role of MR imaging.
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Ema T, Funai K, Kawase A, Oiwa H, Iizuka S, Shiiya N. A solitary fibrous tumor of the pleura for which the tumor doubling time could be calculated by computed tomography: a case report. J Thorac Dis 2018; 10:E592-E595. [PMID: 30174941 DOI: 10.21037/jtd.2018.06.113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Toshinari Ema
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Kazuhito Funai
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Akikazu Kawase
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Hiroaki Oiwa
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Syuhei Iizuka
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Norihiko Shiiya
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan
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Tanaka Y, Nakamoto A, Inada Y, Narumi Y, Hirose Y, Azuma H. A case of malignant solitary fibrous tumor of the prostatic urethra. BJR Case Rep 2018; 4:20180034. [PMID: 30931143 PMCID: PMC6438398 DOI: 10.1259/bjrcr.20180034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/08/2018] [Accepted: 05/23/2018] [Indexed: 12/24/2022] Open
Abstract
A 68-year-old male with dementia presented with gross hematuria. On plain CT, a mass was found at the base of the prostate with intravesical protrusion. On MRI, the mass was well-circumscribed and showed slight hyperintensity compared to the skeletal muscle on T1 weighted imaging and high intensity on T2 weighted imaging. On dynamic study, the tumor showed mild enhancement in the early phase and increased enhancement in the delayed phase, and the mass appeared continuous with the prostatic urethra. On follow-up MRI at approximately 10 months, the mass had increased in size. Pathologically, the tumor was located in the muscularis of the prostatic urethra and consisted of spindle cells with fascicular and storiform patterns of growth, and exhibited strong diffuse expression of CD34. The tumor was hypercellular, and a significant number of mitoses were observed. Therefore, this tumor was diagnosed as malignant solitary fibrous tumor (SFT) of the prostatic urethra.
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Affiliation(s)
- Yoshikazu Tanaka
- Department of Radiology, Osaka Medical College, Takatsuki, Japan
| | - Atsushi Nakamoto
- Department of Radiology, Osaka Medical College, Takatsuki, Japan
| | - Yuki Inada
- Department of Radiology, Osaka Medical College, Takatsuki, Japan
| | - Yoshifumi Narumi
- Department of Radiology, Osaka Medical College, Takatsuki, Japan
| | - Yoshinobu Hirose
- Department of Pathology, Osaka Medical College, Takatsuki, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical College, Takatsuki, Japan
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50
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Chen W, Julius CJ, Elliott RM. Renal angiofibroma: A case report. HUMAN PATHOLOGY: CASE REPORTS 2018. [DOI: 10.1016/j.ehpc.2018.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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