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Arias Rivera AS, Nesme Vara M, Brener Chaoul M, De La Rosa Abaroa MA, Padilla Longoria R. A Giant Malignant Solitary Fibrous Tumor of the Pancreas: A Case Report and Review of the Literature. Cureus 2024; 16:e61467. [PMID: 38953073 PMCID: PMC11215300 DOI: 10.7759/cureus.61467] [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: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
We present a case report of a giant solitary fibrous tumor (SFT) with a review of the literature and discuss its biological features and diagnosis. A 43-year-old man presented to our emergency department with abdominal pain and distension with an evolution of two days. Contrast-enhanced computed tomography (CT) showed a large, well-circumscribed semisolid mass (12 cm x 10 cm x 12 cm) localized in the pancreatic head. The histological diagnosis obtained by endoscopic ultrasound-guided trans-duodenal tumor biopsy with fine-needle aspiration showed proliferating short spindle-shaped cells, suggesting a mesenchymal neoplasia of low grade. We proceeded to a Whipple surgical technique. The histopathological study of the resected tumor confirmed proliferating spindle-shaped cells in the tissue, and one mitotic figure was observed in 10 high-power fields (HPFs). Immunostaining was positive for CD34 and STAT-6. The histological diagnosis was a malignant pancreatic SFT. In the six months posterior to the surgical procedure, the patient has been free of recurrent disease. Preoperative diagnosis is difficult and requires comprehensive evidence including clinical, immunohistochemistry, and histological features. Since there are currently no recognized best practices, we advise total surgical excision and careful clinical monitoring.
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2
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Möller K, Ntovas S, Hocke M, On W, Everett SM, Braden B, Jenssen C, Misselwitz B, Ge N, Sun S, Gerber M, Faiss S, Dietrich CF. Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine guidelines: Rare pancreatic tumors, ultrasound and contrast-enhanced ultrasound features-Malignant mesenchymal tumors. Endosc Ultrasound 2024; 13:55-64. [PMID: 38947746 PMCID: PMC11213603 DOI: 10.1097/eus.0000000000000054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Rare malignant mesenchymal pancreatic tumors are systematized and reported in this review. The focus is on the appearance on imaging. The present overview summarizes the data and shows that not every pancreatic tumor corresponds to the most common entities of ductal adenocarcinoma or neuroendocrine tumor.
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Affiliation(s)
- Kathleen Möller
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Sotirios Ntovas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Hocke
- Medical Department II, Helios Klinikum Meiningen, Germany
| | - Wei On
- Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Simon M. Everett
- Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, United Kingdom
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch-Oderland, Strausberg, Germany
- Brandenburg Institute for Clinical Ultrasound (BICUS) at Medical University Brandenburg, Neuruppin, Germany
| | - Benjamin Misselwitz
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nan Ge
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Siyu Sun
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Michael Gerber
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Siegbert Faiss
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin der Kliniken (DAIM) Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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3
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Wang WW, Zhou SP, Wu X, Wang LL, Ruan Y, Lu J, Li HL, Ni XL, Qiu LL, Zhou XH. Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: A case report and review of literature. World J Clin Cases 2024; 12:995-1003. [PMID: 38414609 PMCID: PMC10895636 DOI: 10.12998/wjcc.v12.i5.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/01/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND A solitary fibrous tumor (SFT) is often located in the pleura, while SFT of the pancreas is extremely rare. Here, we report a case of SFT of the pancreas and discuss imaging, histopathology, and immunohistochemistry for accurate diagnosis and treatment. CASE SUMMARY A 54-year-old man presented to our hospital with pancreatic occupancy for over a month. There were no previous complaints of discomfort. His blood pressure was normal. Blood glucose, tumor markers, and enhanced computed tomography (CT) suggested a malignant tumor. Because the CT appearance of pancreatic cancer varies, we could not confirm the diagnosis; therefore, we performed endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). Pathology and immunohistochemistry were consistent with SFT of the pancreas. The postoperative pathology and immunohistochemistry were consistent with the puncture results. The patient presented for a follow-up examination one month after discharge with no adverse effects. CONCLUSION Other diseases must be excluded in patients with a pancreatic mass that cannot be diagnosed. CT and pathological histology have diagnostic value for pancreatic tumors. Endoscopic puncture biopsy under ultrasound can help diagnose pancreatic masses that cannot be diagnosed preoperatively. Surgery is an effective treatment for SFT of the pancreas; however, long-term follow-up is strongly recommended because of the possibility of malignant transformation of the tumor.
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Affiliation(s)
- Wen-Wen Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Li Huili Hospital, Ningbo University School of Medicine, Ningbo 315000, Zhejiang Province, China
| | - Shu-Ping Zhou
- Ningbo College of Health Sciences, Ningbo College of Health Sciences, Ningbo 315000, Zhejiang Province, China
| | - Xiang Wu
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Li Huili Hospital, Ningbo University School of Medicine, Ningbo 315000, Zhejiang Province, China
- Health Science Center, Ningbo University, Ningbo 315000, Zhejiang Province, China
| | - Luo-Luo Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Li Huili Hospital, Ningbo University School of Medicine, Ningbo 315000, Zhejiang Province, China
| | - Yi Ruan
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Li Huili Hospital, Ningbo University School of Medicine, Ningbo 315000, Zhejiang Province, China
| | - Jun Lu
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China
| | - Hai-Li Li
- Department of Diagnosis, Ningbo Diagnostic Pathology Center, Ningbo 315000, Zhejiang Province, China
| | - Xu-Ling Ni
- Department of Diagnosis, Ningbo Diagnostic Pathology Center, Ningbo 315000, Zhejiang Province, China
| | - Li-Li Qiu
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Li Huili Hospital, Ningbo University School of Medicine, Ningbo 315000, Zhejiang Province, China
| | - Xin-Hua Zhou
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Li Huili Hospital, Ningbo University School of Medicine, Ningbo 315000, Zhejiang Province, China
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4
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Yavas A, Tan J, Ozkan HS, Yilmaz F, Reid MD, Bagci P, Shi J, Shia J, Adsay V, Klimstra DS, Basturk O. Solitary Fibrous Tumor of the Pancreas: Analysis of 9 Cases With Literature Review. Am J Surg Pathol 2023; 47:1230-1242. [PMID: 37573546 PMCID: PMC10592360 DOI: 10.1097/pas.0000000000002108] [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] [Indexed: 08/15/2023]
Abstract
Solitary fibrous tumor (SFT) has been increasingly reported in various anatomic sites. However, it is still extremely rare in the pancreas. Herein, we present the first series of primary pancreatic SFTs. Nine cases of primary pancreatic SFTs were analyzed. The mean age was 60 years (36 to 76 y) with no sex predilection. Six tumors were in the head, 3 were in the tail. On imaging studies, tumors were described as a hypervascular mass, 2 revealed cystic areas, and 3 were favored to be neuroendocrine tumors. On biopsy, 2 cases were diagnosed as atypical spindle cell tumor; one was misdiagnosed as suspicious for sarcoma, and another case as metastatic renal cell carcinoma. Two were diagnosed as low-grade sarcoma and low-grade stromal tumor on frozen sections. Grossly, tumors were well-demarcated with a median size of 4 cm (0.9 to 15 cm). Microscopically, they were composed of ovoid to spindle tumor cells with no significant mitotic activity and were arranged in alternating hypercellular and hypocellular areas. Staghorn-like vessels and entrapped pancreatic parenchyma were also detected within all tumors. Tumor cells revealed diffuse/strong nuclear STAT6 expression in 7 of 8, CD34 in 7 of 9, and bcl-2 in 4 of 4 tested cases. One tested tumor harbored NAB2 - STAT6 fusion. Eight patients with available follow-up data were free of disease at a mean follow-up of 76 months (3 to 189 mo). SFT should be considered in the differential diagnoses of mesenchymal neoplasms of the pancreas. Immunohistochemical nuclear STAT6 expression is a characteristic feature of SFT. Primary pancreatic SFTs seem to have favorable biological behavior in our series.
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Affiliation(s)
- Aslihan Yavas
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Hulya Sahin Ozkan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Funda Yilmaz
- Department of Pathology, Ege University, Izmir, Turkey
| | - Michelle D Reid
- Department of Pathology, Emory University Hospital, Atlanta, GA, USA
| | - Pelin Bagci
- Department of Pathology, Marmara University, Istanbul, Turkey
| | - Jiaqi Shi
- Department of Pathology and Clinical Labs, University of Michigan, Ann Arbor, MI, USA
| | - Jinru Shia
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Volkan Adsay
- Department of Pathology, Koc University, Istanbul, Turkey
| | - David S. Klimstra
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Olca Basturk
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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5
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Jones VM, Wangsiricharoen S, Cornea V, Bocklage TJ, Ali SZ, Allison DB. Cytopathological characteristics of solitary fibrous tumour involving the pancreas by fine needle aspiration: Making an accurate preoperative diagnosis in an uncommon location. Cytopathology 2021; 33:222-229. [PMID: 34551176 DOI: 10.1111/cyt.13061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/05/2021] [Accepted: 09/18/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Solitary fibrous tumour (SFT) is a unique mesenchymal neoplasm with classic features on histology and is characterised by the NAB2-STAT6 gene fusion. There are rare reports of SFTs with pancreatic involvement and only two cases in the literature reporting its features by preoperative fine needle aspiration (FNA). Herein, we characterise the cytomorphological features of four SFTs involving the pancreas by FNA to establish a preoperative diagnostic approach. METHODS The anatomic pathology archives of two academic medical centres were searched to identify patients with a pancreatic FNA cytology specimen and a confirmed diagnosis of SFT by surgical resection. The clinical history, pathological diagnosis, cytomorphological findings, and results of immunohistochemistry (IHC) were reviewed. RESULTS Four SFTs were identified from four patients with a median age of 59 years. The morphological features were variable but most frequently showed a bland spindled-to-epithelioid proliferation in fragments and single cells with small, oval, elongated, and hypochromatic nuclei in a haphazard arrangement with or without dense collagen. One tumour presented with a concurrent metastasis and showed a pure epithelioid component with necrosis and enlarged, hyperchromatic nuclei with conspicuous nucleoli and scattered mitoses. IHC was necessary for all diagnoses which were confirmed by surgical resection. CONCLUSIONS SFTs with pancreatic involvement are rare, and non-specific features and tumour heterogeneity can pose a diagnostic challenge on FNA; however, IHC can be used to make a definitive diagnosis. As a result, FNA is a simple, safe, cost-effective, and accurate approach that can be used to diagnose SFT in the pancreas.
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Affiliation(s)
- Victoria M Jones
- Department of Pathology & Laboratory Medicine, University of Kentucky College of Medicine, Lexington, KY, USA
| | | | - Virgilius Cornea
- Department of Pathology & Laboratory Medicine, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Therese J Bocklage
- Department of Pathology & Laboratory Medicine, University of Kentucky College of Medicine, Lexington, KY, USA.,Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Syed Z Ali
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Derek B Allison
- Department of Pathology & Laboratory Medicine, University of Kentucky College of Medicine, Lexington, KY, USA.,Markey Cancer Center, University of Kentucky, Lexington, KY, USA
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Taguchi Y, Hara T, Tamura H, Ogiku M, Watahiki M, Takagi T, Harada T, Miyazaki S, Hayashi T, Kanai T, Mori H, Ozawa T, Nishiwaki Y. Malignant solitary fibrous tumor of the pancreas: a case report. Surg Case Rep 2020; 6:287. [PMID: 33188464 PMCID: PMC7666235 DOI: 10.1186/s40792-020-01067-6] [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: 07/31/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022] Open
Abstract
Background Solitary fibrous tumors (SFTs) are rare tumors, mostly derived from connective tissue mesenchymal cells that arise from the pleura. There are very few reports of primary pancreatic SFT. Preoperative diagnosis is difficult owing to the lack of distinctive radiological findings. We report a case of pancreatic SFT with particularly rare malignant findings. Case presentation A 60-year-old man was referred to the hospital because of a right upper quadrant mass and abnormal liver function test results. Contrast-enhanced computed tomography (CT) showed a well-defined enhanced tumor measuring approximately 8 cm in the pancreatic head. Magnetic resonance imaging (MRI) showed T1WI hypointensity, T2WI hyperintensity, and DWI hyperintensity. The main pancreatic duct and common bile duct were dilated owing to obstruction by the tumor. The following tumor markers were mildly elevated: carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), SPan-1, and DUPAN-2. The histological diagnosis obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was negative for pancreatic ductal carcinoma, malignant lymphoma and neuroendocrine tumor, suggesting the possibility of mesenchymal tumor, but the diagnosis was not confirmed. The patient was judged suitable for surgery and underwent subtotal stomach-preserving pancreatoduodenectomy with D2 lymph node dissection. On histopathological examination of the resected specimen, infiltrating spindle-shaped cells had proliferated, containing numerous mitotic figures, with necrotic findings inside the tumor. Immunostaining was positive for cluster of differentiation-34 (CD34), B cell CLL/lymphoma-2 (Bcl-2), and signal transducer and activator of transcription (STAT6). On the basis of these findings, a diagnosis of malignant pancreatic SFT was made. The patient remains free of recurrent disease after 12 months of follow-up without adjuvant therapy and he is being carefully followed up as an outpatient. Conclusions We experienced a case of malignant pancreatic head SFT. Immunohistochemical staining of the extracted specimens was useful for diagnosis.
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Affiliation(s)
- Yuka Taguchi
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Takanobu Hara
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan. .,Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan.
| | - Hiroaki Tamura
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Masahito Ogiku
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Mana Watahiki
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Toru Takagi
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Takashi Harada
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Shinichiro Miyazaki
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Tadataka Hayashi
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Toshikazu Kanai
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Hiroki Mori
- Department of Pathology, Hamamatsu Medical Center, 328 Tomitsuka-cho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Takachika Ozawa
- Department of Pathology, Hamamatsu Medical Center, 328 Tomitsuka-cho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
| | - Yoshiro Nishiwaki
- Department of Gastroenterological Surgery, Hamamatsu Medical Center, 328 Tomitsukacho, Naka-ku, Hamamatsu city, Shizuoka, 432-8580, Japan
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Li J, Li J, Xiong Y, Xu T, Xu J, Li Q, Yang G. Atypical/malignant solitary fibrous tumor of the pancreas with spleen vein invasion: Case report and literature review. Medicine (Baltimore) 2020; 99:e19783. [PMID: 32332621 PMCID: PMC7220729 DOI: 10.1097/md.0000000000019783] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor that is most common in the pleura. However, according to previous studies, the SFT of the pancreas is extremely rare; only 20 cases have been reported so far. Here, we conduct a literature review and report the first case of atypical/malignant SFT of the pancreas with spleen vein invasion. PATIENT CONCERNS The patient is a 61-year-old Chinese male who presented with 1 week of upper abdominal pain. Abdominal magnetic resonance imaging showed a huge mass (>10 cm) at the distal end of the pancreas, and the mass obstructing the splenic vein. DIAGNOSIS Atypical/malignant SFT of the pancreas with splenic vein tumor thrombus. INTERVENTIONS The patient underwent laparoscopic distal pancreatectomy with splenectomy procedure to achieve a radical resection, and did not undergo chemotherapy or radiotherapy. OUTCOMES Abdominal computed tomography scans were performed at 1 and 4 months after resection, and no signs of recurrence or metastasis were found (. B).(Figure is included in full-text article.) CONCLUSION:: The clinical symptoms of atypical/malignant SFT of the pancreas with spleen vein invasion are not atypical, and imaging feature is lack of specificity. Preoperative diagnosis is difficult, and there is a potential for malignancy. However, due to the paucity of randomized control trials, there is no established, globally accepted treatment strategy, radiation therapy and chemotherapy regimens have not demonstrated global effectiveness, and no standardized treatments have been identified. Therefore, we recommend complete surgical resection and close clinical follow-up.
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Affiliation(s)
- Jingdong Li
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College
- Institute of Hepato-Biliary-Intestinal Disease, North Sichuan Medical College
| | - Jiangpeng Li
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College
- Institute of Hepato-Biliary-Intestinal Disease, North Sichuan Medical College
| | - Yongfu Xiong
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College
- Institute of Hepato-Biliary-Intestinal Disease, North Sichuan Medical College
| | - Ting Xu
- Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jian Xu
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College
- Institute of Hepato-Biliary-Intestinal Disease, North Sichuan Medical College
| | - Qiang Li
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College
- Institute of Hepato-Biliary-Intestinal Disease, North Sichuan Medical College
| | - Gang Yang
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College
- Institute of Hepato-Biliary-Intestinal Disease, North Sichuan Medical College
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Qian X, Zhou D, Gao B, Wang W. Metastatic solitary fibrous tumor of the pancreas in a patient with Doege-Potter syndrome. Hepatobiliary Surg Nutr 2020; 9:112-115. [PMID: 32140495 DOI: 10.21037/hbsn.2019.12.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Xiaohui Qian
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
| | - Dongkai Zhou
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
| | - Bingqiang Gao
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
| | - Weilin Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
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9
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Geng H, Ye Y, Jin Y, Li BZ, Yu YQ, Feng YY, Li JT. Malignant solitary fibrous tumor of the pancreas with systemic metastasis: A case report and review of the literature. World J Clin Cases 2020; 8:343-352. [PMID: 32047784 PMCID: PMC7000951 DOI: 10.12998/wjcc.v8.i2.343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/18/2019] [Accepted: 12/22/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pancreatic solitary fibrous tumor (SFT) is a rare neoplasm of intermediate biological potential. So far, only 22 cases have been reported since 1999. All the cases, except one, exhibited benign features. Here, we report the first case of malignant pancreatic SFT with typical Doege-Potter syndrome, along with the clinical and pathologic evidence of its systemic metastasis.
CASE SUMMARY The patient was a 48-year-old man with a 1-year history of pancreatic and liver masses and refractory hypoglycemia. Increased uptake of the tracer fluorodeoxyglucose (FDG) was found in the liver and bones by fluorine-18 FDG positron emission tomography/computed tomography. After multidisciplinary discussion, a distal pancreatectomy procedure was performed, and histological examination showed a lesion composed of abundant heterogeneous spindle cells with localized necrosis. On immunohistochemistry evaluation, STAT6 was found to be diffusely expressed in the tumor. Based on the overall evidence, the patient was diagnosed with malignant pancreatic SFT with liver and bone metastases.
CONCLUSION The diagnosis of malignant SFT requires comprehensive evidence including clinical, immunohistochemistry, and histological features. This case may be presented as a reference for diagnoses and management of malignant pancreatic SFTs with systemic metastasis.
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Affiliation(s)
- Hao Geng
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yu Ye
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yun Jin
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Bai-Zhou Li
- Department of Pathology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yuan-Quan Yu
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yang-Yang Feng
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Jiang-Tao Li
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
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10
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Yamashita H, Fujino Y, Ohara T, Kakinoki K, Sugimoto T, Kajimoto K, Tominaga M. A rare case of metastatic solitary fibrous tumor of the pancreas manifesting as a cystic neoplasm: a case report. Surg Case Rep 2019; 5:142. [PMID: 31520184 PMCID: PMC6744537 DOI: 10.1186/s40792-019-0699-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/27/2019] [Indexed: 12/17/2022] Open
Abstract
Background Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that typically arises from the pleura. Although it may appear in other organs, it rarely develops in the pancreas. We report herein a rare case of metastatic SFT of the pancreas originating from an intracranial tumor and subsequently identified as a cystic neoplasm of the pancreas. Case presentation A 58-year-old woman with a past medical history of brain tumor visited the hospital for further investigation of a cystic tumor in the pancreas tail. Abdominal imaging showed a heterogeneously enhancing mass that was initially suspected as a neuroendocrine neoplasm, solid pseudopapillary neoplasm, or mucinous cystic neoplasm of the pancreas. Distal pancreatectomy was performed without any intraoperative and postoperative complications. Pathological findings confirmed a diagnosis of malignant SFT of the pancreas with hyperproliferative potential. A histopathological review of her brain tumor revealed that the pancreatic tumor was derived from her brain lesion. The patient developed recurrent brain disease 4 years after the pancreatectomy, but no recurrence has been observed in the abdominal cavity. Conclusions SFT should be considered in the differential diagnosis of untypical hypervascular pancreatic mass, particularly in patients with a history of an intrathoracic or intracranial mesenchymal tumor. Immunohistochemical analysis is crucial in detecting this tumor entity. Hyperproliferative status indicates a malignant disease and requires careful postoperative observation.
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Affiliation(s)
- Hironori Yamashita
- Department of Gastroenterological Surgery, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi-Shi, Hyogo, 673-8558, Japan.
| | - Yasuhiro Fujino
- Department of Gastroenterological Surgery, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi-Shi, Hyogo, 673-8558, Japan
| | - Tadayuki Ohara
- Department of Gastroenterological Surgery, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi-Shi, Hyogo, 673-8558, Japan
| | - Keitaro Kakinoki
- Department of Gastroenterological Surgery, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi-Shi, Hyogo, 673-8558, Japan
| | - Takemi Sugimoto
- Department of Gastroenterological Surgery, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi-Shi, Hyogo, 673-8558, Japan
| | - Kazuyoshi Kajimoto
- Department of Pathology, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi-Shi, Hyogo, 673-8558, Japan
| | - Masahiro Tominaga
- Department of Gastroenterological Surgery, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi-Shi, Hyogo, 673-8558, Japan
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