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Fat-forming solitary fibrous tumor of the sacrum: A case report and literature review. Radiol Case Rep 2021; 16:1874-1877. [PMID: 34113409 PMCID: PMC8170013 DOI: 10.1016/j.radcr.2021.04.052] [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: 12/01/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
Fat-forming variant of solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm. Here we report the case of a 33-year-old woman who developed pain and muscle weakness from the posterior aspect of the right hip to lower extremity. Imaging examinations revealed a mass with fatty components and hypervascular solid components filling the sacral spinal canal and sacral foramen. The sacral mass was resected and histological examination of the specimens revealed patternless proliferation of short spindle-shaped cells with staghorn blood vessels. A number of mature adipocyte-like cells were also observed. The tumor cells were positive for STAT6 and the nuclei of the adipocytes were also positive, which was diagnostic for fat-forming SFT.
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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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3
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Bacalbasa N, Balescu I, Jinescu G, Marcu M, Contolenco A, Pop D, Dobritoiu D, Ionescu O, Ionescu P, Stoica C. Fat-forming Solitary Fibrous Tumor of the Kidney - A Case Report and Literature Review. ACTA ACUST UNITED AC 2018; 32:649-652. [PMID: 29695573 DOI: 10.21873/invivo.11288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 01/29/2018] [Accepted: 02/08/2018] [Indexed: 01/21/2023]
Abstract
Fat-forming solitary fibrous tumors arising from the kidney are extremely rare, with only few cases reported so far. We report the case of a 49-year-old patient investigated for lumbar pain and diagnosed preoperatively with a large retroperitoneal tumor destroying the right kidney. The patient was submitted to surgery, the tumor being resected en bloc with right nephrectomy. The histopathological studies demonstrated the presence of a hemangiopericytoma-like tumor with adipocytary component; the immunohistochemical studies demonstrated the presence of cluster of differentiation 34 (CD34), while human melanoma black (HMB45) staining was negative. Therefore, the diagnostic of fat-forming solitary fibrous tumor of the kidney was established. The postoperative outcome was uneventful, the patient being discharged on the sixth postoperative day. In conclusion, although fat-forming solitary fibrous tumor of the kidney is a very rare entity, this diagnosis should be taken into consideration whenever a large retroperitoneal mass with high adipose content and renal invasion is described at the preoperative studies.
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Affiliation(s)
- Nicolae Bacalbasa
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Obstetrics and Gynecology, Dr. Ioan Cantacuzino Clinical Hospital, Bucharest, Romania
| | - Irina Balescu
- Department of General Surgery, Ponderas Academic Hospital, Bucharest, Romania
| | - George Jinescu
- Department of General Surgery, Floreasca Emergency Clinic Hospital, Bucharest, Romania
| | - Madalina Marcu
- Department of Pathology, Ilfov Clinical County Hospital, Bucharest, Romania
| | - Andreea Contolenco
- Department of Pathology, Ilfov Clinical County Hospital, Bucharest, Romania
| | - Doina Pop
- Department of Pathology Victor Babes National Institute of Pathology, Bucharest, Romania
| | - Dragos Dobritoiu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Obstetrics and Gynecology, Dr. Ioan Cantacuzino Clinical Hospital, Bucharest, Romania
| | - Olivia Ionescu
- Department of Obstetrics and Gynecology, Fichtelgebirge Hospital, Marktredwitz, Germany
| | - Paris Ionescu
- Department of Obstetrics and Gynecology, Ovidius University of Medicine, Constanta, Romania
| | - Claudia Stoica
- Department of General Surgery, Ilfov Clinical County Hospital, Bucharest, Romania
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Lang N, Zhang E, Xing X, Yuan H. Solitary fibrous tumour of the spine: imaging features of a commonly misdiagnosed entity. Eur Radiol 2018; 28:3986-3995. [PMID: 29619522 DOI: 10.1007/s00330-018-5349-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/06/2018] [Accepted: 01/23/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Solitary fibrous tumours (SFTs) occurring in the spine are rare. Herein, we review the clinical and imaging data of spinal SFT. METHODS We retrospectively analysed eight cases of pathologically confirmed spinal SFT imaging and clinical data, pathological manifestations, surgical methods, and follow-up results. RESULTS Five SFTs cases occurred in the cervical spine, two in the thoracic spine, and one in the lumbosacral spine. Five cases showed a dumbbell-shaped or lobulated soft tissue mass that grew across the intervertebral foramen, two cases showed an expansive intraosseous mass formation in the vertebral body and/or posterior element, and one case showed a long-spindle shaped intraspinal canal mass growing along the spinal canal. Seven caused local invasion and destruction of the vertebral body and posterior element. Benign SFTs displayed a good prognosis, whereas malignant SFTs were prone to recurrence and metastasis (3/4). CONCLUSION Spinal SFTs are difficult to characterise with imaging and required pathological and immunohistochemical investigation. Prolonged follow-up is recommended once a diagnosis of spinal SFTs has been established because of the unclear biology. KEY POINTS • Spinal solitary fibrous tumours are extremely rare. • SFTs should be showed the differential of masses developing though the foramen. • Combing imaging with pathology and immunochemistry assesses the diagnosis and establish nature.
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Affiliation(s)
- Ning Lang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
| | - Enlong Zhang
- Department of Radiology, Peking University International Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiaoying Xing
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
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Albert GW, Gokden M. Solitary fibrous tumors of the spine: a pediatric case report with a comprehensive review of the literature. J Neurosurg Pediatr 2017; 19:339-348. [PMID: 28106515 DOI: 10.3171/2016.10.peds16279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Solitary fibrous tumors of the spine are rare lesions. Their description in the literature is limited to case reports and small case series. While generally benign lesions, they can recur and occasionally occur as malignancies. Here the authors present the case of a 10-year-old boy, the youngest patient and first preadolescent reported thus far, with this condition. In addition, they perform a comprehensive review of all previously published cases of spinal solitary fibrous tumors.
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Affiliation(s)
- Gregory W Albert
- Division of Neurosurgery, Arkansas Children's Hospital; and.,Departments of 2 Neurosurgery and
| | - Murat Gokden
- Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Solitary fibrous tumour with intramedullary component: Case report and review of the literature. Neurol Neurochir Pol 2014; 48:144-9. [DOI: 10.1016/j.pjnns.2013.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 09/02/2013] [Indexed: 11/20/2022]
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Tomek M, Bravi I, Mendoza N, Alsafi A, Mehta A, Molinaro L, Singh P, Radotra B, Dei Tos AP, Roncaroli F. Spinal extradural solitary fibrous tumor with retiform and papillary features. Ann Diagn Pathol 2013; 17:281-7. [DOI: 10.1016/j.anndiagpath.2013.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 01/12/2013] [Accepted: 01/13/2013] [Indexed: 10/27/2022]
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Park CY, Rho JY, Yoo SM, Jung HK. Fat-forming variant of solitary fibrous tumour of the pleura: CT findings. Br J Radiol 2011; 84:e203-5. [PMID: 22011822 DOI: 10.1259/bjr/68692634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The fat-forming variant of solitary fibrous tumour (SFT) was previously called lipomatous haemangiopericytoma and is a rare variant of solitary fibrous tumour. It predominantly occurs in the deep soft tissues of the retroperitoneum and thigh. Only a handful of cases involving the perineum, spine, thoracic wall and pelvic cavity have been reported in the radiological literature and the fat-forming variant of SFT involving the pleura has not been previously reported. Herein, we report the CT findings of a case of the fat-forming variant of SFT involving the pleura that was treated by excision. Chest CT showed a large lobulated heterogeneous fatty mass with a multifocal enhancing soft-tissue component in the left lower hemithorax. Although rare, the fat-forming variant of SFT of the pleura should be added to the differential diagnosis of fat-containing pleural soft-tissue tumours.
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Affiliation(s)
- C Y Park
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Korea
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Jing HB, Meng QD, Tai YH. Lipomatous hemangiopericytoma of the stomach: A case report and a review of literature. World J Gastroenterol 2011; 17:4835-8. [PMID: 22147987 PMCID: PMC3229635 DOI: 10.3748/wjg.v17.i43.4835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 06/21/2011] [Accepted: 06/29/2011] [Indexed: 02/06/2023] Open
Abstract
Lipomatous hemangiopericytomas (LHPCs) are rare soft-tissue tumors that are histologically characterized by hemangiopericytomatous vasculature and the presence of mature adipocytes. We present the clinicopathological features of a case of gastric LHPC in a 56-year-old female, along with a literature review. Endoscopy and endoscopic ultrasound showed a submucosal tumor 0.8 cm across in the greatest dimension in the lesser curvature side of the gastric antrum. Grossly, the well-defined mass had a solid and tan-white cut surface admixed with myxoid regions and yellowish areas. Histological examination revealed a submucosal well-circumscribed lesion composed of cellular nodules with the classic appearance of an hemangiopericytoma admixed with clusters and lobules of mature adipocytes. The ill-defined tumor cells had weakly eosinophilic cytoplasm and contained spindled nuclei with occasional small nucleoli. Nuclei atypia and mitoses were absent, and no cellular atypia, necrosis or vascular invasion was observed. Immunohistochemistry showed that the tumor cells were diffusely positive for CD34, CD99, and vimentin and were focally reactive for bcl-2. This is the first known report of an LHPC in the stomach. The patient was followed for 12 mo without any evidence of metastasis or recurrence.
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Solitary fibrous tumor of the central nervous system: a 15-year literature survey of 220 cases (August 1996-July 2011). Adv Anat Pathol 2011; 18:356-92. [PMID: 21841406 DOI: 10.1097/pap.0b013e318229c004] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We reviewed the world literature on solitary fibrous tumors of the central nervous system from August 1996 to July 2011, focusing on both clinicopathological features and diagnostic findings. The anatomical distribution of the 220 cases reported so far reveals that most are intracranial and just over one-fifth are intraspinal. In decreasing frequency, intracranial tumors involve the supratentorial and infratentorial compartments, the pontocerebellar angle, the sellar and parasellar regions, and the cranial nerves. Intraspinal tumors are mainly located in the thoracic and cervical segments. Although most solitary fibrous tumors of the central nervous system are dural based, a small subset presents as subpial, intraparenchymal, intraventricular, or as tumors involving the nerve rootlets with no dural connection. Preoperative imaging and intraoperative findings suggest meningioma, schwannoma or neurofibroma, hemangiopericytoma, or pituitary tumors. Immunohistochemistry is critical to establish a definitive histopathological diagnosis. Vimentin, CD34, BCL2, and CD99 are the most consistently positive markers. The usual histologic type generally behaves in a benign manner if complete removal is achieved. Recurrence is anticipated when resection is subtotal or when the tumor exhibits atypical histology. The proliferative index as assessed by MIB1 labeling is of prognostic significance. Occasionally, tumors featuring conventional morphology may recur, perhaps because of minimal residual disease left behind during surgical extirpation. Rare extracranial metastases and tumor-related deaths are on record. Surgery is the treatment of choice. Stereotactic and external beam radiation therapy may be indicated for postsurgical tumor remnants and for unresectable recurrences. Long-term active surveillance of the patients is mandatory.
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