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Chenhui Z, He G, Wu Z, Rong J, Ma F, Wang Z, Fang J, Gao W, Song H, Zhang F, Di G, Jiang X. Intracranial solitary fibrous tumor/hemangiopericytomas: a clinical analysis of a series of 17 patients. Br J Neurosurg 2024; 38:617-624. [PMID: 34334066 DOI: 10.1080/02688697.2021.1944980] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/21/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Solitary fibrous tumors (SFTs) and haemangiopericytomas (HPCs) are rare mesenchymal tumors in central nervous system (CNS). Although progressed recognition to the diagnosis and treatment of SFT/HPCs, it still remains many confusions regarding on its occurrence, aggressive evolution, malignant transformation, dedifferentiation phenomenon, distant metastasis and unpredictable propensity. PATIENTS AND METHODS Seventeen cases of CNS SFT/HPCs who underwent surgical treatment from January 2010 to December 2020 were collected in the authors' institute. Clinical, radiological, pathological data and followup details were reviewed in all cases. RESULTS The age of this series was 41-73 years old. Seven cases located subtentorially, five cases originated from middle skull base and four in supratentorial. MRI shows iso-signal intensity on T1WI, and heterogeneous slightly long/short signal on T2WI. There is significant contrast after gadolinium-enhancement. It is easy to be misdiagnosed before surgery. The positive rate of nuclear STAT6 is 94.12%, higher than CD34 (87.5%). Eight patients were grade I, eight grade II and one in grade III. Five cases developed tumor relapse, in which two cases had local intracranial recurrence combined with dissemination and metastasis of cerebrospinal fluid in the spinal canal, accompanied by pathological malignant transformation, and another one occurred blood metastasis. CONCLUSIONS CNS SFT/HPCs are rare intracranial tumors with unpredictable propensity. Gross total resection is critical to its overall clinical prognosis. Given its potential recurrence and malignant transition, adjuvant radiotherapies are recommended when necessary, and long-term follow-up is indispensable. The underlying molecular biological mechanisms are still needed to be further exploration.
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Affiliation(s)
- Zhao Chenhui
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Guoyuan He
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zeyu Wu
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jun Rong
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Fengchun Ma
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zhichun Wang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jincheng Fang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Wanwan Gao
- Department of Pathology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Hong Song
- Department of Pathology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Fan Zhang
- Department of Pathology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Guangfu Di
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Xiaochun Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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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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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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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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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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Zhao M, He H, Cao D, Fan D, Xu M, Zhang X, Ru G. Solitary Fibrous Tumor With Extensive Epithelial Inclusions. Am J Clin Pathol 2022; 158:35-46. [PMID: 34999741 DOI: 10.1093/ajcp/aqab211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/16/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Solitary fibrous tumor (SFT) harboring extensive epithelial inclusions is rare and can stimulate a biphasic neoplasm composed of epithelial and stromal elements. METHODS Three cases of SFT with extensive epithelial inclusions were retrieved. H&E stain, immunohistochemical stain, and targeted next-generation sequencing were performed. RESULTS There were two male patients and one female patient aged 54, 32, and 68 years. All tumors were located in abdominopelvic sites involving the kidney (case 1), omentum (case 2), and prostate (case 3), respectively. Microscopically, all tumors were circumscribed and composed of a background of SFT admixed with randomly embedded glands or cysts, organizing sometimes in a phyllodes-like architecture. The covered epithelium displayed a range of morphologies from simple cystic to stratified and to complex papillary proliferation. Immunohistochemically, both STAT6 and CD34 were expressed in the spindle cells but not in the epithelial inclusions. RNA sequencing revealed fusions involving NAB2~STAT6 in all cases. DNA sequencing demonstrated TERT c.-124C>T mutation in case 1. Prognostic stratification scores were intermediate in case 1 and low in cases 2 and 3. CONCLUSIONS SFT with extensive epithelial inclusions represents a rare but potentially underrecognized variant of SFT and shows compatible molecular features with conventional SFT.
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Affiliation(s)
- Ming Zhao
- Cancer Center, Department of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Huiying He
- Department of Pathology, School of Basic Medical Sciences, Third Hospital, Peking University Health Science Center, Beijing, China
| | - Dengfeng Cao
- Department of Pathology, Shanghai CoreOne Pathology Diagnostics, Shanghai, China
| | - Dage Fan
- Department of Pathology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Mingxin Xu
- Department of Pathology, Tongxiang First People’s Hospital, Jiaxing, China
| | - Xin Zhang
- Cancer Center, Department of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Guoqing Ru
- Cancer Center, Department of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, China
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Ambardjieva M, Saidi S, Jovanovic R, Janculev J, Stankov V, Trifunovski A, Popov Z. Solitary Fibrous Tumor of Adrenal Gland and Review of the Literature. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2021; 42:63-69. [PMID: 35032374 DOI: 10.2478/prilozi-2021-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Solitary fibrous tumor (SFT) is a rare and still controversial entity. This type of tumor first appeared in the literature as a pleural lesion, but, over the last decades, it has been reported in many extrathoracic sites. As a tumor of the adrenal gland, SFT is still rare and very uncommon, thus extensive research among the English language literature has been performed. We present here a case report of an adrenal SFT which is compared to 11 other known cases. Our case report is from a patient with SFT on the left adrenal gland, followed by mild symptoms of abdominal discomfort and hypertension. Physical examination, laboratory, and radiological tests were performed. The patient underwent surgery and the material was sent for histopathologic analysis for a definite diagnosis. Regular follow up appointments were performed over the course of two years. No recurrence of the tumor has been detected. We explain the symptoms, diagnosis, treatment, and additionally we describe the results and implications of the findings reported in the literature. Correct diagnosis is mandatory for optimal management of solitary fibrous tumor patients.
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Affiliation(s)
- Martina Ambardjieva
- University clinic for urology, Faculty of medicine, Ss. Cyril and Methodius University in Skopje, Skopje R. N. Macedonia
| | - Skender Saidi
- University clinic for urology, Faculty of medicine, Ss. Cyril and Methodius University in Skopje, Skopje R. N. Macedonia
| | - Rubens Jovanovic
- Institute of Pathology, Faculty of medicine, Ss. Cyril and Methodius University in Skopje, Skopje, R. N. Macedonia
| | - Josif Janculev
- University clinic for urology, Faculty of medicine, Ss. Cyril and Methodius University in Skopje, Skopje R. N. Macedonia
| | - Viktor Stankov
- University clinic for urology, Faculty of medicine, Ss. Cyril and Methodius University in Skopje, Skopje R. N. Macedonia
| | - Aleksandar Trifunovski
- University clinic for urology, Faculty of medicine, Ss. Cyril and Methodius University in Skopje, Skopje R. N. Macedonia
| | - Zivko Popov
- Macedonian Academy of Sciences and Arts, Skopje, R. N. Macedonia
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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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9
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Tran TAN. Primary cutaneous solitary fibrous tumor with entrapped eccrine components. J Cutan Pathol 2020; 47:845-849. [PMID: 32314418 DOI: 10.1111/cup.13717] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/05/2020] [Accepted: 04/15/2020] [Indexed: 12/23/2022]
Abstract
First described in the pleura, solitary fibrous tumor (SFT) was subsequently reported in a variety of organ systems. Compared to other anatomic sites, primary cutaneous and superficial SFTs are relatively rare. Although several histopathologic variants of cutaneous and superficial SFT have been described, a primary cutaneous SFT harboring glandular components has not hitherto been documented in the literature. The current case report describes a spindle cell neoplasm of the right finger in a female patient with characteristic morphologic and immunohistochemical features of a SFT. Unexpectedly, various glandular and ductal components were identified in the SFT. A few hyperplastic lobules of sweat glands demonstrating similar morphology as the intratumoral glandular components and composed of secretory coils displaying mucinous metaplasia and ducts were detected in the attached subcutaneous tissue, suggestive of an inductive or obstructive effect of the SFT on the eccrine units. The intratumoral glands and ducts were judged to represent entrapped benign eccrine components from the attached subcutaneous tissue. Since this variant of SFT with entrapped eccrine components could mimic many biphasic epithelial and stromal tumors, pathologists should be aware of this unusual variant of SFT to avoid potential erroneous diagnosis, particularly mistaken confusion with a biphasic synovial sarcoma.
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Affiliation(s)
- Tien Anh N Tran
- Department of Pathology, Advent Health Orlando, Orlando, Florida, USA
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10
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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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11
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Basturk O, Weigelt B, Adsay V, Benhamida JK, Askan G, Wang L, Arcila ME, Zamboni G, Fukushima N, Gularte-Mérida R, Da Cruz Paula A, Selenica P, Kumar R, Pareja F, Maher CA, Scholes J, Oda Y, Santini D, Doyle LA, Petersen I, Flucke U, Koelsche C, Reynolds SJ, Yavas A, von Deimling A, Reis-Filho JS, Klimstra DS. Sclerosing epithelioid mesenchymal neoplasm of the pancreas - a proposed new entity. Mod Pathol 2020; 33:456-467. [PMID: 31383964 PMCID: PMC7000300 DOI: 10.1038/s41379-019-0334-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 02/07/2023]
Abstract
We have encountered pancreatic tumors with unique histologic features, which do not conform to any of the known tumors of the pancreas or other anatomical sites. We aimed to define their clinicopathologic features and whether they are characterized by recurrent molecular signatures. Eight cases were identified; studied histologically and by immunohistochemistry. Selected cases were also subjected to whole-exome sequencing (WES; n = 4), RNA-sequencing (n = 6), Archer FusionPlex assay (n = 5), methylation profiling using the Illumina MethylationEPIC (850k) array platform (n = 6), and TERT promoter sequencing (n = 5). Six neoplasms occurred in females. The mean age was 43 years (range: 26-75). Five occurred in the head/neck of the pancreas. All patients were treated surgically; none received neoadjuvant/adjuvant therapy. All patients are free of disease after 53 months of median follow-up (range: 8-94). The tumors were well-circumscribed, and the median size was 1.8 cm (range: 1.3-5.8). Microscopically, the unencapsulated tumors had a geographic pattern of epithelioid cell nests alternating with spindle cell fascicles. Some areas showed dense fibrosis, in which enmeshed tumor cells imparted a slit-like pattern. The predominant epithelioid cells had scant cytoplasm and round-oval nuclei with open chromatin. The spindle cells displayed irregular, hyperchromatic nuclei. Mitoses were rare. No lymph node metastases were identified. All tumors were positive for vimentin, CD99 and cytokeratin (patchy), while negative for markers of solid pseudopapillary neoplasm, neuroendocrine, acinar, myogenic/rhabdoid, vascular, melanocytic, or lymphoid differentiation, gastrointestinal stromal tumor as well as MUC4. Whole-exome sequencing revealed no recurrent somatic mutations or amplifications/homozygous deletions in any known oncogenes or tumor suppressor genes. RNA-sequencing and the Archer FusionPlex assay did not detect any recurrent likely pathogenic gene fusions. Single sample gene set enrichment analysis revealed that these tumors display a likely mesenchymal transcriptomic program. Unsupervised analysis (t-SNE) of their methylation profiles against a set of different mesenchymal neoplasms demonstrated a distinct methylation pattern. Here, we describe pancreatic neoplasms with unique morphologic/immunophenotypic features and a distinct methylation pattern, along with a lack of abnormalities in any of key genetic drivers, supporting that these neoplasms represent a novel entity with an indolent clinical course. Given their mesenchymal transcriptomic features, we propose the designation of "sclerosing epithelioid mesenchymal neoplasm" of the pancreas.
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Affiliation(s)
- Olca Basturk
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Volkan Adsay
- Department of Pathology, Koç University, Istanbul,
Turkey
| | - Jamal K. Benhamida
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Gokce Askan
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Lu Wang
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Maria E. Arcila
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Giuseppe Zamboni
- Department of Pathology, University of Verona and IRCCS
Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | | | | | - Arnaud Da Cruz Paula
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Pier Selenica
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Rahul Kumar
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Fresia Pareja
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | | | - John Scholes
- Department of Pathology, St. Francis Hospital and Medical
Center, Hartford, CT, USA
| | - Yoshinao Oda
- Department of Pathology, Kyushu University, Fukuoka,
Fukuoka Prefecture, Japan
| | - Donatella Santini
- Department of Pathology, Azienda Ospedaliera-Universitaria
di Bologna, Italy
| | - Leona A. Doyle
- Department of Pathology, Brigham and Women’s
Hospital, Boston, MA, USA
| | - Iver Petersen
- Department of Pathology, SRH Poliklinik Gera GmbH, Gera,
Germany
| | - Uta Flucke
- Department of Pathology, Radboud University Medical
Center, Nijmegen, The Netherlands
| | | | | | - Aslihan Yavas
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - Andreas von Deimling
- Department of Pathology, University Hospital Heidelberg
and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jorge S. Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
| | - David S. Klimstra
- Department of Pathology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
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12
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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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13
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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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14
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Gebresellassie HW, Mohammed Y, Kotiso B, Amare B, Kebede A. A giant solitary fibrous tumor of the adrenal gland in a 13-year old: a case report and review of the literature. J Med Case Rep 2019; 13:246. [PMID: 31391097 PMCID: PMC6686402 DOI: 10.1186/s13256-019-2163-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/18/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Solitary fibrous tumors are tumors of mesenchymal origin that occur in the extremities and occasionally in pleura, meninges, and so on, but are extremely rare in the adrenal gland. Their biological behavior is variable but mostly benign. CASE PRESENTATION A 13-year-old Oromo girl presented with a progressively increasing right upper abdominal mass of 3 years' duration. She had dull dragging pain and an occasional low-grade fever. On examination she had 20 × 20 cm mass with well-defined medial and inferior border. Both ultrasound and computed tomography scan showed a highly vascularized mass arising from her right adrenal gland but she had neither the constitutional symptoms of a functional adrenal tumor nor an abnormal biochemical test. Surgical resection showed a vascularized mass with attachments to the right lobe of the liver with a weight of 1900 g. It was found to be a giant solitary fibrous tumor of her right adrenal gland with infrequent mitosis. She stayed for 5 days after surgery and was discharged. She showed remarkable recovery at follow-up at 3 months. CONCLUSION Although very rare, solitary fibrous tumor of the adrenal gland should be considered in differential diagnosis of adrenal masses.
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Affiliation(s)
| | | | - Brahenu Kotiso
- Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Bereket Amare
- Department of Pathology, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
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15
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Manning MA, Paal EE, Srivastava A, Mortele KJ. Nonepithelial Neoplasms of the Pancreas, Part 2: Malignant Tumors and Tumors of Uncertain Malignant Potential From the Radiologic Pathology Archives. Radiographics 2018; 38:1047-1072. [PMID: 29787363 DOI: 10.1148/rg.2018170201] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Almost all neoplasms of the pancreas are derived from pancreatic epithelial components, including the most common pancreatic mass, primary pancreatic ductal adenocarcinoma (PDAC). Nonepithelial neoplasms comprise only 1%-2% of all pancreatic neoplasms. Although some may arise directly from intrapancreatic elements, many originate from mesenchymal, hematopoietic, or neural elements in the retroperitoneal peripancreatic space and grow into the pancreas. Once these tumors reach a certain size, it can be challenging to identify their origin. Because these manifest at imaging as intrapancreatic masses, awareness of the existence and characteristic features of these nonepithelial neoplasms is crucial for the practicing radiologist in differentiating these tumors from primary epithelial pancreatic tumors, an important distinction given the vastly different management and prognosis. In part 1 of this article, the authors reviewed benign nonepithelial neoplasms of the pancreas. This article focuses on malignant nonepithelial neoplasms and those of uncertain malignant potential that can be seen in the pancreas. The most common malignant or potentially malignant nonepithelial pancreatic tumors are of mesenchymal origin and include soft-tissue sarcomas, solitary fibrous tumor, and inflammatory myofibroblastic tumor. These tumors commonly manifest as large heterogeneous masses, often containing areas of necrosis and hemorrhage. The clinical features associated with these tumors and the imaging characteristics including enhancement patterns and the presence of fat or calcification help distinguish these tumors from PDAC. Hematopoietic tumors, including lymphoma and extramedullary plasmacytoma, can manifest as isolated pancreatic involvement or secondarily involve the pancreas as widespread disease. Hyperenhancing paragangliomas or hypervascular metastatic disease can mimic primary pancreatic neuroendocrine tumors or vascular anomalies.
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Affiliation(s)
- Maria A Manning
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1010, Silver Spring, MD 20910 (M.A.M.); Department of Radiology, MedStar Georgetown University Hospital, Washington, DC (M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); Department of Radiology, MetroWest Medical Center, Framingham, Mass (A.S.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (K.J.M.)
| | - Edina E Paal
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1010, Silver Spring, MD 20910 (M.A.M.); Department of Radiology, MedStar Georgetown University Hospital, Washington, DC (M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); Department of Radiology, MetroWest Medical Center, Framingham, Mass (A.S.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (K.J.M.)
| | - Amogh Srivastava
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1010, Silver Spring, MD 20910 (M.A.M.); Department of Radiology, MedStar Georgetown University Hospital, Washington, DC (M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); Department of Radiology, MetroWest Medical Center, Framingham, Mass (A.S.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (K.J.M.)
| | - Koenraad J Mortele
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1010, Silver Spring, MD 20910 (M.A.M.); Department of Radiology, MedStar Georgetown University Hospital, Washington, DC (M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); Department of Radiology, MetroWest Medical Center, Framingham, Mass (A.S.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (K.J.M.)
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16
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Takahashi H, Ogata S, Domoto H, Oda T, Kawaguchi S, Kato K, Teramura Y, Nakanishi K. A mass protruding from the pancreas featuring extensive myxoid change. Cytojournal 2018; 15:9. [PMID: 29599814 PMCID: PMC5865278 DOI: 10.4103/cytojournal.cytojournal_24_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/29/2017] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hiromi Takahashi
- Address: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Sho Ogata
- Address: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hideharu Domoto
- Address: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Tomohiro Oda
- Address: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Saki Kawaguchi
- Address: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Kei Kato
- Address: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Yasuyo Teramura
- Department of Radiology, National Defense Medical College, Tokorozawa, Japan
| | - Kuniaki Nakanishi
- Address: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan.,Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
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17
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Oana S, Matsuda N, Sibata S, Ishida K, Sugai T, Matsumoto T. A case of a "wandering" mobile solitary fibrous tumor occurring in the pancreas. Clin J Gastroenterol 2017; 10:535-540. [PMID: 28956313 DOI: 10.1007/s12328-017-0774-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 09/01/2017] [Indexed: 02/07/2023]
Abstract
A 73-year-old male with a complaint of abdominal discomfort was examined by abdominal ultrasonography and found to have a hypoechoic mass in the upper abdomen. On abdominal computed tomography (CT), there was a 5-cm, hypervascular mass between the stomach and aorta. Magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) showed a homogeneous mass with hypointensity on T1-weighted images, accompanied by stenosis of the main pancreatic duct of the pancreatic head. On endoscopic ultrasonography, the mass was depicted as a round homogeneous, hypervascular mass attached to the pancreatic head. Surprisingly, the mass was located on the right side of the aorta on the second CT. Histological examination of the resected specimen showed that the lesion was composed of spindle cells with cord-like arrangement, the features of which were compatible with a mobile solitary fibrous tumor.
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Affiliation(s)
- Shuhei Oana
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka, Iwate, 020-8505, Japan.
| | - Nozomi Matsuda
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka, Iwate, 020-8505, Japan
| | - Sho Sibata
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka, Iwate, 020-8505, Japan
| | - Kazuyuki Ishida
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Tamotsu Sugai
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka, Iwate, 020-8505, Japan
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18
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Spasevska L, Janevska V, Janevski V, Noveska B, Zhivadinovik J. Solitary Fibrous Tumor of the Pancreas: A Case Report and Review of the Literature. ACTA ACUST UNITED AC 2017; 37:115-120. [PMID: 27883325 DOI: 10.1515/prilozi-2016-0024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Pancreas is an extremely rare abdominal localization of the solitary fibrous tumor (SFT). It usually grows asymptomatically for a long time before a diagnosis can be made on the basis of symptoms and/or mechanical complications. Due to the rarity and nonspecific clinical presentation, this entity is diagnostically challenging. We present a 47-year-old man with a history of progressive epigastric pain for the last two weeks, and jaundice, who was admitted to hospital for further investigation. Cystadenocarcinoma was suspected based on the radiologic findings, and a pancreatoduodenectomy was performed. The removed portion of the pancreas contained a 3.5 × 2 × 1.8 cm well-circumscribed, but not encapsulated white tumor mass with smooth cut surface, cystic component and duct dilatation within the tumor and within the adjacent pancreatic tissue. Based on the histology and immunostaining profile, a diagnosis of the solitary fibrous tumor was made. One week post-operatively, the patient died due to surgical complications. Microscopic and immunohistochemical examinations are necessary for accurate diagnosis of cystic SFT of the pancreas. Because there is limited data regarding the biological behavior of SFT with extra-pleural localization the authors recommend clinical follow-up for SFT treatment if the criteria of malignancy are not met.
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19
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Sheng Q, Xu W, Liu J, Shen B, Deng X, Wu Y, Wu W, Yu S, Wang X, Lv Z. Pancreatic solitary fibrous tumor in a toddler managed by pancreaticoduodenectomy: a case report and review of the literature. Onco Targets Ther 2017; 10:1853-1858. [PMID: 28392706 PMCID: PMC5376181 DOI: 10.2147/ott.s133650] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Solitary fibrous tumor (SFT) of the pancreas is rare, with 15 adult cases reported in the English literature. We described a 14-month-old boy who presented with obstructive jaundice. Dominantly elevated serum CA19-9 was detected. Imaging studies revealed a well-circumscribed, solid mass in the pancreatic head. A pancreaticoduodenectomy (child procedure) was performed using Shen’s anastomosis technique. After resection of the tumor, liver function and serum tumor markers normalized and clinical signs receded. The boy was disease free after a follow-up of 12 months. Histological examination showed the tumor consisted of “patternless pattern” arranged spindle tumor cells and keloid-like hyalinized collagen. Immunohistochemical staining was positive for CD34 and vimentin. Mutation analysis of CTNNB1 was negative. To the best of our knowledge, our patient was the first case of pancreatic SFT in a pediatric population. SFT should be considered in differential diagnosis when confronted with a pancreatic tumor in children. Complete resection should be meticulously pursued.
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Affiliation(s)
- Qingfeng Sheng
- Department of General Surgery, Shanghai Children's Hospital
| | - Weijue Xu
- Department of General Surgery, Shanghai Children's Hospital
| | - Jiangbin Liu
- Department of General Surgery, Shanghai Children's Hospital
| | | | | | - Yibo Wu
- Department of General Surgery, Shanghai Children's Hospital
| | - Wei Wu
- Department of General Surgery, Shanghai Children's Hospital
| | - Shenghua Yu
- Department of General Surgery, Shanghai Children's Hospital
| | - Xueli Wang
- Department of Pathology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Zhibao Lv
- Department of General Surgery, Shanghai Children's Hospital
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20
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Murakami K, Nakamura Y, Felizola SJA, Morimoto R, Satoh F, Takanami K, Katakami H, Hirota S, Takeda Y, Meguro-Horike M, Horike SI, Unno M, Sasano H. Pancreatic solitary fibrous tumor causing ectopic adrenocorticotropic hormone syndrome. Mol Cell Endocrinol 2016; 436:268-73. [PMID: 27585487 DOI: 10.1016/j.mce.2016.08.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 08/26/2016] [Accepted: 08/28/2016] [Indexed: 12/11/2022]
Abstract
Solitary fibrous tumors occasionally present with hypoglycemia because of the excessive release of insulin-like growth factor II. We report the first case of pancreatic solitary fibrous tumor causing ectopic adrenocorticotropic hormone syndrome. An 82-year-old Japanese man presented with lower limb edema, uncontrolled hypertension, hypokalemia, and baseline hypercortisolism. Distal pancreatectomy was performed after the clinical diagnosis of a neuroendocrine tumor with ectopic secretion of adrenocorticotropic hormone. On histological examination, the tumor showed spindle cells in a fascicular arrangement. The diagnosis of the solitary fibrous tumor was confirmed by the identification of the NAB2-STAT6 fusion gene and positive immuno-histochemical staining for STAT6 and CD34. Using quantitative real-time polymerase chain reaction, mRNA that encoded proopiomelanocortin, precursor of adrenocorticotropic hormone, was detected. Proopiomelanocortin production through the demethylation of the promoter region Domain IV was detected. Pancreatic solitary fibrous tumors represent a new cause of ectopic adrenocorticotropic hormone syndrome.
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Affiliation(s)
- Keigo Murakami
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan.
| | - Yasuhiro Nakamura
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Saulo J A Felizola
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Ryo Morimoto
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Fumitoshi Satoh
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Kentaro Takanami
- Department of Radiology, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Hideki Katakami
- Clinical Research Science, Department of Medicine, Teikyo University Chiba Medical Center, Chiba, 299-0111, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, 663-8501, Japan
| | - Yoshiyu Takeda
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, 920-0934, Japan
| | - Makiko Meguro-Horike
- Advanced Science Research Center, Institute for Gene Research, Kanazawa University, Kanazawa, 920-0934, Japan
| | - Shin-Ichi Horike
- Advanced Science Research Center, Institute for Gene Research, Kanazawa University, Kanazawa, 920-0934, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Hironobu Sasano
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
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21
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Paramythiotis D, Kofina K, Bangeas P, Tsiompanou F, Karayannopoulou G, Basdanis G. Solitary fibrous tumor of the pancreas: Case report and review of the literature. World J Gastrointest Surg 2016; 8:461-466. [PMID: 27358679 PMCID: PMC4919714 DOI: 10.4240/wjgs.v8.i6.461] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 03/18/2016] [Indexed: 02/06/2023] Open
Abstract
Solitary fibrous tumor (SFT) is a mesenchymal tumor typically located in the pleura, but can also be found as an asymptomatic mass in other areas, including the liver, peritoneum, kidney and salivary glands. However, SFT rarely locates in the pancreas. We present such a case of pancreatic SFT, along with a review of all reported cases. A 55-year-old man was treated surgically for an asymptomatic pancreatic mass after a rigorous preoperative control. Histologic examination of the resected specimen showed characteristics of an SFT. As only 15 cases of pancreatic SFT have been reported so far, an attempt to compare the cases was considered intriguing. We found that patients with pancreatic SFT were mainly women (81.25%), with a median age of 54 years at the time of diagnosis and a median tumor size of 5.83 cm. Pancreatic SFTs were revealed incidentally in 50% of cases, and all of them showed an enhancement through arterial computed tomography. All tumors were positive for CD34, ten were positive for Bcl-2, and twelve were negative for S100. The diagnosis of this pancreatic tumor is established by a combination of clinical suspicion, imaging procedures and histological findings, and is confirmed by immunohistochemical staining. Although the behavior of SFTs is rather benign, close clinical follow-up is recommended due to a potentially malignant nature.
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22
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Abstract
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms of fibroblastic origin. Most commonly they affect the pleura but they been described in other viscera. SFT of the pancreas is extremely rare, and only eight cases have been reported to date. We perform a literature review and report a ninth case. The patient is a 54-year-old African-American female who presented with several months of abdominal pain. Abdominal radiography demonstrated a lesion in the head of the pancreas, and she underwent a Whipple operation. Pathology demonstrated SFT of the pancreas. She is alive and well 1 year post-operatively. SFT of the pancreas predominately affects middle-aged women. These tumors are difficult to distinguish radiologically from neuroendocrine tumors. While SFT of the pancreas tend to have an indolent course, there is the potential for malignancy. We recommend complete surgical excision.
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Affiliation(s)
- Andrew R Baxter
- Department of Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Elliot Newman
- Department of Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Cristina H Hajdu
- Department of Pathology, New York University Langone Medical Center, New York, NY, USA
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23
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Abstract
Solitary fibrous tumor (SFT) arising in the pancreas is exceedingly rare, with only 11 cases reported in the English literature. All cases described thus far have exhibited benign histology. We report the first case of malignant SFT of the pancreas. The patient was a 52-year-old woman who presented with obstructive jaundice and a 15-cm pancreatic head mass. The mass showed areas with typical histologic features for SFT including small fibroblastlike cells arranged in the well-characterized "patternless pattern" of architecture, hemangiopericytomalike vessels, areas with dense collagen and infrequent mitoses (0-2 per 10 high-power fields [HPFs]). In addition, multiple areas with an overtly sarcomatous morphology were present, containing large spindle and epithelioid cells with nuclear pleomorphism, marked cellularity, up to17 mitoses per 10 HPFs, and necrosis. Immunohistochemical stains were positive for CD34 and B-cell CLL/lymphoma 2 (Bcl-2) in both benign and malignant components and showed strong, diffuse p53 and p16 staining in the malignant component. At last follow-up (40 months), the patient was alive and well without evidence of disease. However, given that the presence of a malignant component in extrapancreatic SFT has been associated with recurrence/metastasis and death, complete surgical resection and close long-term follow-up is required.
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24
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Han SH, Baek YH, Han SY, Lee SW, Jeong JS, Cho JH, Kwon HJ. Solitary Fibrous Tumor of the Pancreas: A Case Report and Review of the Literature. ACTA ACUST UNITED AC 2015. [DOI: 10.3904/kjm.2015.88.3.293] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Seung Hee Han
- Devision of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Yang Hyun Baek
- Devision of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sang-young Han
- Devision of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sung Wook Lee
- Devision of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Jin Sook Jeong
- Department of Pathology, Dong-A University College of Medicine, Busan, Korea
| | - Jin Han Cho
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
| | - Hee-Jin Kwon
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
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25
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Abstract
OBJECTIVE Primary mesenchymal tumors of the pancreas are extremely rare and no comprehensive study of this class of tumors has been previously performed. METHODS Twenty cases of the primary mesenchymal tumors of the pancreas were selected and compared clinicopathologic variables with consecutively resected 500 pancreatic ductal adenocarcinomas. RESULTS Finally, 20 (0.3%) cases were confirmed as primary mesenchymal tumors. The 14 (70%) cases of benign/borderline tumors included 4 cases of fibromatoses, 2 cases of cavernous hemangiomas, 2 cases of schwannomas, 2 cases of solid and cystic hamartomas, 2 cases of solitary fibrous tumors, 1 case of inflammatory myofibroblastic tumor, and 1 case of angiomyolipoma. The 6 (30%) cases of sarcomas comprised 3 cases of undifferentiated/unclassified sarcomas, 1 case of leiomyosarcoma, 1 case of Ewing sarcoma/primitive neuroectodermal tumor, and 1 case of atypical lipomatous tumor/well-differentiated liposarcoma. When compared with the 500 ductal adenocarcinomas, the 3 surgically resected sarcomas were larger (mean, 5.8 cm vs 3.6 cm; P = 0.02); however, no difference in median survival time was observed between patients with sarcoma (23 months) and patients with ductal adenocarcinoma (16 months). CONCLUSIONS First, primary mesenchymal tumors of the pancreas are extremely rare. Second, several primary mesenchymal tumor types can be observed in the pancreas. Understanding these rare disease entities will help ensure their correct diagnosis.
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26
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Solitary fibrous tumor of neck mimicking cold thyroid nodule in 99m tc thyroid scintigraphy. Case Rep Endocrinol 2013; 2013:805745. [PMID: 24194989 PMCID: PMC3806406 DOI: 10.1155/2013/805745] [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: 08/04/2013] [Accepted: 08/28/2013] [Indexed: 11/17/2022] Open
Abstract
A 68-year-old man had a rapidly growing, painless neck mass, thought to be nodular goiter. Ultrasonography showed a giant, heterogeneous mass occupying the middle and superior poles and protruding outside of the left thyroid lobe. The results of the thyroid function tests were normal. Thyroid scintigraphy revealed a large hypoactive nodule in the left thyroid lobe. Complete surgical removal of tumor was performed and macroscopically demonstrated a well-demarked lesion outside the thyroid gland. Microscopically, the lesion was composed of fibroblast-like spindle cells in a patternless architecture and extensive stromal hyalinization. Immunohistochemistry showed positive reaction for CD34 in spindle cells and diffuse bcl-2 staining. The pathology was confirmed as solitary fibrous tumor. In the follow-up period after surgery, thyroid scintigraphy showed normal left thyroid lobe. Solitary fibrous tumor originated from or associated with thyroid gland is extremely rare. According to our knowledge, this is the first reported solitary fibrous tumor presenting like a cold thyroid nodule. This pathology must be considered for differential diagnosis of neck masses in the thyroid region.
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Abstract
Extrathoracic solitary fibrous tumors (SFTs) have been described at almost every anatomic location of human body, but reports of SFT in the abdominal cavity are rare. We herein present a rare case of SFT originating from greater omentum. Computed tomography revealed a 15.8 cm × 21.0 cm solid mass located at superior aspect of stomach. Open laparotomy confirmed its mesenchymal origin. Microscopically, its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei, which were divided up by branching vessel and collagen bundles. Immunohistochemical staining showed that this tumor was negative for CD117, CD99, CD68, cytokeratin, calretinin, desmin, epithelial membrane antigen, F8 and S-100, but positive for CD34, bcl-2, α-smooth muscle actin and vimentin. The patient presented no evidence of recurrence during follow-up. SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers, especially for CD34 and bcl-2 positive cases.
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28
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van der Vorst JR, Vahrmeijer AL, Hutteman M, Bosse T, Smit VTHBM, van de Velde CJH, Frangioni JV, Bonsing BA. Near-infrared fluorescence imaging of a solitary fibrous tumor of the pancreas using methylene blue. World J Gastrointest Surg 2012; 4:180-4. [PMID: 22905287 PMCID: PMC3420986 DOI: 10.4240/wjgs.v4.i7.180] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 03/27/2012] [Accepted: 06/05/2012] [Indexed: 02/06/2023] Open
Abstract
A 67-year-old female presented with unexplained abdominal pain. A contrast-enhanced computed tomography scan of the abdomen incidentally revealed a mass in the uncinate process of the pancreas. This mass was resected and based on histopathological findings, diagnosed as a solitary fibrous tumor (SFT) of the pancreas. A SFT is an extremely rare benign mesenchymal tumor that in 65% of cases affects the visceral pleura but can also affect extra-pleural sites. The intraoperative demarcation of pancreatic tumors, such as SFTs, can be challenging. In this report, the first clear intraoperative identification of a SFT of the pancreas in a human was shown using near-infrared fluorescence and methylene blue.
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Affiliation(s)
- Joost R van der Vorst
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
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29
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Febrero B, Robles R, Brusadin R, Marín C, López-Conesa A, Martínez C, Parrilla P. Liver and pancreatic metastasis of a solitary fibrous tumour. Cir Esp 2012; 92:438-41. [PMID: 22824532 DOI: 10.1016/j.ciresp.2012.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Revised: 04/13/2012] [Accepted: 04/30/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Beatriz Febrero
- Servicio de Cirugía General, Hospital Universitario Virgen de la Arrixaca, Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Murcia, España.
| | - Ricardo Robles
- Servicio de Cirugía General, Hospital Universitario Virgen de la Arrixaca, Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Murcia, España
| | - Roberto Brusadin
- Servicio de Cirugía General, Hospital Universitario Virgen de la Arrixaca, Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Murcia, España
| | - Caridad Marín
- Servicio de Cirugía General, Hospital Universitario Virgen de la Arrixaca, Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Murcia, España
| | - Asunción López-Conesa
- Servicio de Cirugía General, Hospital Universitario Virgen de la Arrixaca, Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Murcia, España
| | - Cristina Martínez
- Servicio de Medicina Interna-Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - Pascual Parrilla
- Servicio de Cirugía General, Hospital Universitario Virgen de la Arrixaca, Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Murcia, España
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30
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Ho YH, Yap WM, Chuah KL. Solitary fibrous tumor of the adrenal gland with unusual immunophenotype: a potential diagnostic problem and a brief review of endocrine organ solitary fibrous tumor. Endocr Pathol 2010; 21:125-9. [PMID: 20191330 DOI: 10.1007/s12022-010-9113-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Solitary fibrous tumor was initially thought to be a pleura-based tumor. However, over the last two decades, its involvement in a variety of extrapleural sites gained recognition. Nonetheless, a primary involvement of the endocrine organs is rare, and in this report, we detail an instance where the tumor affected the adrenal gland of a 71-year-old Arab man. On histology, besides the typical morphologic features seen in solitary fibrous tumor, the neoplasm also exhibited unusual features on immunohistochemistry such as positive staining for cytokeratin AE1/3 and calponin in conjunction with diffuse expression for S-100. The genetic tests for t(X:18) as seen in synovial sarcoma were negative, and the overall histological appearance favored a diagnosis of solitary fibrous tumor. To the best of our knowledge, this report represents the fifth case of a solitary fibrous tumor primarily occurring in the adrenal gland. The differential diagnoses of this neoplasm in our case and a brief summary of solitary fibrous tumor primarily involving the various endocrine organs are presented.
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Affiliation(s)
- Yong Howe Ho
- Department of Pathology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
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31
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Alonso I, Hernández-Guerra M, González Y, Gimeno-García A, Méndez R, Malagón A, Quintero Carrión E. [Intraabdominal mass with difficult diagnosis: Solitary fibrous tumor]. GASTROENTEROLOGIA Y HEPATOLOGIA 2010; 33:303-6. [PMID: 20206414 DOI: 10.1016/j.gastrohep.2009.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 12/04/2009] [Accepted: 12/12/2009] [Indexed: 11/26/2022]
Abstract
Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin. The most commonly reported locations are the pleura and meninges. Less frequently, SFT manifests as an asymptomatic mass in the pancreas, liver, peritoneum or kidney. Clinical and radiological findings have failed to provide any specific diagnostic pattern but allow malignant development to be suspected due to infiltration or metastasis. In addition, preoperative cytology often yields inconclusive or misleading results. Therefore the definitive diagnosis is achieved after both surgical resection and immunohistochemical analysis, with markers such as CD34, vimentin and desmin. We present a case of SFT, which was difficult to diagnose, even after an extensive battery of tests based on imaging techniques.
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Affiliation(s)
- Inmaculada Alonso
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Tenerife, España
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