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Marcinkevičiūtė K, Jagelavičius Ž, Žurauskas E, Janilionis R. Giant intrapulmonary solitary fibrous tumor with signs of malignancy. J Surg Case Rep 2024; 2024:rjad741. [PMID: 38239376 PMCID: PMC10795905 DOI: 10.1093/jscr/rjad741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024] Open
Abstract
Solitary fibrous tumor (SFT) is an extremely rare mesenchymal neoplasm usually detected in the pleura, which generally follows a benign course. The localization inside lung parenchyma has more rarely been reported. We present a case of a 51-year-old male with a dry cough, dyspnea, chest pain, and increased perspiration. Radiological images revealed a giant circumscribed mass on the right side of the chest. A transbronchial cryobiopsy of the lung was performed and revealed an SFT. The right upper lobectomy through lateral thoracotomy was performed. The pathological examination confirmed an SFT with a central zone of necrosis that is a sign of malignancy. At a 2-year follow-up, the patient is free of symptoms and with no evidence of recurrence. Although the intrapulmonary localization of an SFT is a rare entity, we should be aware of it as a potential malignant pulmonary neoplasm.
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Affiliation(s)
| | - Žymantas Jagelavičius
- Department of Thoracic Surgery, Center of Cardio-Thoracic Surgery, Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius LT-08661, Lithuania
| | - Edvardas Žurauskas
- Department of Pathology and Forensic Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius LT-08406, Lithuania
| | - Ričardas Janilionis
- Department of Thoracic Surgery, Center of Cardio-Thoracic Surgery, Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius LT-08661, Lithuania
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Takehara M, Ashihara K, Fukunishi T, Ibuchi S, Mukai Y. Malignant retroperitoneal solitary fibrous tumor co-existing with Meigs' syndrome: A case report. Radiol Case Rep 2023; 18:4553-4557. [PMID: 37868006 PMCID: PMC10587666 DOI: 10.1016/j.radcr.2023.09.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023] Open
Abstract
Malignant solitary fibrous tumors in the retroperitoneum are rare, and their treatment strategies have not yet been established. A 61-year-old woman with dyspnea underwent laparotomy under a presumptive diagnosis of Meigs' syndrome. She underwent both adnexectomy and retroperitoneal tumor excision. The histologic diagnosis was of a fibrothecoma of both ovaries and a retroperitoneal solitary fibrous tumor that was considered malignant based on its mitotic activity. Local recurrence was observed 9 months postoperatively; re-excision was performed, and radiation therapy was administered. Four months later, metastasis to the left lung was detected, and a thoracoscopic resection was performed. Although pazopanib was administered subsequently, it was discontinued after 11 months because of proteinuria. She complained of dysphagia 3 weeks after the withdrawal of the drug, and a metastatic tumor was observed at the cranial base. Radiotherapy was initiated; however, she died of the disease 35 months after the primary surgery. Medical guidelines should be established for malignant solitary fibrous tumors to improve patient prognosis.
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Affiliation(s)
- Mikio Takehara
- Department of Obstetrics and Gynecology, Ikeda City Hospital, 3-1-18 Jyonan, Ikeda City, Osaka 563-8510, Japan
| | - Keisuke Ashihara
- Department of Obstetrics and Gynecology, Ikeda City Hospital, 3-1-18 Jyonan, Ikeda City, Osaka 563-8510, Japan
| | - Tomomi Fukunishi
- Department of Obstetrics and Gynecology, Ikeda City Hospital, 3-1-18 Jyonan, Ikeda City, Osaka 563-8510, Japan
| | - Seigo Ibuchi
- Department of Obstetrics and Gynecology, Ikeda City Hospital, 3-1-18 Jyonan, Ikeda City, Osaka 563-8510, Japan
| | - Yukari Mukai
- Department of Obstetrics and Gynecology, Ikeda City Hospital, 3-1-18 Jyonan, Ikeda City, Osaka 563-8510, Japan
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Kumar K, Kumar P, Bhatia M, Garg A. Solitary Fibrous Tumor of Internal Jugular Vein: An Extremely Rare Entity with Review of Literature. Indian J Radiol Imaging 2021; 31:484-487. [PMID: 34556936 PMCID: PMC8448228 DOI: 10.1055/s-0041-1734352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm that commonly arises from pleura. In the last decade, multiple case reports have described its diverse occurrence in extrapleural locations involving almost every anatomic site. Intravascular SFT is extremely rare and has been reported in inferior vena cava and renal vein only, to the best of our knowledge. SFT of the internal jugular vein has never been reported. We present a case of a SFT arising from internal jugular vein with extraluminal exophytic component extending into supraclavicular fossa. It should also be considered as a differential diagnosis for neoplasm arising from the internal jugular vein.
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Affiliation(s)
- Khemendra Kumar
- Deparment of Radiology, Fortis Escorts Heart Institute, New Delhi, India
| | - Parveen Kumar
- Deparment of Radiology, Fortis Escorts Heart Institute, New Delhi, India
| | - Mona Bhatia
- Deparment of Radiology, Fortis Escorts Heart Institute, New Delhi, India
| | - Amit Garg
- Deparment of Radiology, Fortis Escorts Heart Institute, New Delhi, India
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Li YN, Li CL, Liu ZH. Dumbbell-shaped solitary fibrous tumor in the parapharyngeal space: A case report. World J Clin Cases 2021; 9:1204-1209. [PMID: 33644185 PMCID: PMC7896643 DOI: 10.12998/wjcc.v9.i5.1204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/03/2020] [Accepted: 12/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFTs) occurring in the parapharyngeal space are rare, and their final diagnosis depends on pathological and immunohistochemical analyses. Once the tumor is diagnosed, complete resection and regular postoperative follow-up are required.
CASE SUMMARY A 40-year-old male patient with a right parotid gland mass discovered 8 years ago was admitted to hospital. The mass showed no tenderness or local skin redness. Imaging was carried out as the patient had stable vital signs and showed that the mass was a dumbbell-shaped tumor comprising a superficial tumor approximately 5 cm long and 3 cm wide in size that compressed the right parotid gland and a deep tumor located in the right parapharyngeal space approximately 4.5 cm long and 2.5 cm wide in size. Both tumors were connected in the middle. Prior to surgery, the tumors were considered to be parapharyngeal schwannomas. During surgical dissection, the tumors were found to be smooth and tough, without obvious adhesion to the surrounding tissues. The tumors were revealed to be a SFT following postoperative pathological analysis.
CONCLUSION SFTs in the parapharyngeal space are rarely reported, and complete resection of such tumor is recommended. Adjuvant chemoradiotherapy is used in patients with extensive tumor invasion to lower the recurrence rate. Postoperative long-term follow-up is required.
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Affiliation(s)
- Yu-Nuo Li
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Chun-Lei Li
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Zhao-Hui Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
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Sun H, He S, Zhao Y, Ye C, Yang X, Xu W, Xiao J. Clinical features and prognostic factors of spinal fibroblastic/myofibroblastic tumors: a long-term, single-center, retrospective study. PeerJ 2020; 8:e10530. [PMID: 33362974 PMCID: PMC7749654 DOI: 10.7717/peerj.10530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 11/18/2020] [Indexed: 11/20/2022] Open
Abstract
Background Spinal fibroblastic and myofibroblastic tumors (FMTs) are extremely rare. Few studies have reported on the features and outcomes of this condition that affects the axial skeleton. We explored the clinical characteristics and factors affecting the prognosis of spinal FMTs. Methods We retroactively assessed the survival of 51 patients with spinal FMTs who underwent surgical and adjuvant treatments in our center between April 2006 and September 2018. Factors affecting disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan–Meier method. Variables with p value ≤ 0.05 were subjected to multivariate analysis using the Cox proportional hazards regression model. A two-sided P value < 0.05 was considered statistically significant. Results The mean follow-up period was 50.8 ± 35.6 months (Range 4.2–172.6). Kaplan–Meier survival curves showed that the 5-year DFS was 10% (95% CI [31.09-42.56]) and the 5-year OS was 53% (95% CI [61.28–97.20]). Multivariate analysis showed that en bloc excision was associated with better DFS (HR 0.214, 0.011) and OS (HR 0.273, 0.043), radiotherapy negatively affected OS (HR 0.353, 0.033), and the recurrence and Ki-67 index <5% significantly affected DFS (HR 3.008, 0.008 and 2.754, 0.029). Conclusions Spinal FMTs are rare. Surgery is the treatment of choice and en bloc excision is strongly recommended to improve outcomes. Disease recurrence and the Ki-67 marker are correlated with the progression of these tumors.
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Affiliation(s)
- Haitao Sun
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Shanghai, China
| | - Shaohui He
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Shanghai, China
| | - Yuechao Zhao
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Shanghai, China
| | - Chen Ye
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Shanghai, China
| | - Xinghai Yang
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Shanghai, China
| | - Wei Xu
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Shanghai, China
| | - Jianru Xiao
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Shanghai, China
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Retroperitoneal Sarcomas: An Update on the Diagnostic Pathology Approach. Diagnostics (Basel) 2020; 10:diagnostics10090642. [PMID: 32867125 PMCID: PMC7555595 DOI: 10.3390/diagnostics10090642] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 02/07/2023] Open
Abstract
Retroperitoneal sarcomas are a heterogenous group of rare tumors arising in the retroperitoneum. Retroperitoneal sarcomas comprise approximately 10% of all soft tissue sarcomas. Though any soft tissue sarcoma histologic types may arise in the retroperitoneal space, liposarcoma (especially well-differentiated and dedifferentiated types) and leiomyosarcoma do so most commonly. Retroperitoneal sarcomas are diagnostically challenging, owing to their diversity and morphological overlap with other tumors arising in the retroperitoneum. An accurate diagnosis is necessary for correct management and prognostication. Herein, we provide an update on the diagnostic approach to retroperitoneal sarcomas and review their key histologic findings and differential diagnoses.
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Kaya EA, Carlson JD, Thomas CJ, Wagner AE, Fairbanks RK, Lamoreaux WT, Lee CM. Single Solitary Fibrous Tumor Brain Metastasis in a Patient with Simultaneous Adenocarcinoma of the Lung: Case Report and Review of the Literature. Case Rep Med 2020; 2020:3938270. [PMID: 32318112 PMCID: PMC7166291 DOI: 10.1155/2020/3938270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/24/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022] Open
Abstract
We present a unique case of a patient simultaneously diagnosed with solitary fibrous tumor (SFT) and unrelated adenocarcinoma of the lung, both proven with separate pathology. It was subsequently found that the SFT had metastasized to the brain by additional pathology, and not the predicted adenocarcinoma. SFTs are a rare mesenchymal neoplasm that accounts for less than 2% of all reported soft tissue tumors. SFTs most commonly arise in the thoracic cavity, but are frequently found in various locations throughout the body, and rarely metastasize to the brain. This case highlights that rare neoplasms, such as SFT, should not be ruled out as a potential cause of metastasis. Due to the rarity of this clinical situation, we also provide a review and discussion of previously reported SFT cases and the use of postoperative radiation therapy. The optimal treatment for individual patients remains unclear in this unique situation. Surgical resection followed by adjuvant Gamma Knife radiation therapy to the surgical bed appears to be a safe option for local treatment of SFT in select patients. Further studies are needed of this rare clinical situation in order to better understand and optimize future treatments for patients with SFT and metastasis to the brain.
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Affiliation(s)
- Erin A Kaya
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
- Washington State University (WSU) Elson S. Floyd College of Medicine (ESFCOM), Spokane, WA, USA
| | | | | | - Aaron E Wagner
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Robert K Fairbanks
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Wayne T Lamoreaux
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Christopher M Lee
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
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Fan J, Qiu J, Wei Q. Extremely rare case of intravascular solitary fibrous tumour in the inferior vena cava with review of the literature. Diagn Pathol 2019; 14:86. [PMID: 31391089 PMCID: PMC6686241 DOI: 10.1186/s13000-019-0862-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 07/17/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Solitary fibrous tumour (SFT) is a mesenchymal tumour of fibroblastic type, and it develops in almost any part of the human body. However, according to previous studies, the occurrence of intravascular SFTs is extremely rare. CASE PRESENTATION We reported a case of intravascular SFT in a 67-year-old woman who has been experiencing swelling and pain in the right leg for 2 months. Computed tomography venography scan revealed a well-defined mass obstructing the inferior vena cava (IVC). Surgical resection was performed, and histopathologic and immunohistochemical results were consistent with SFT. Further, next-generation sequencing (NGS) analysis was performed, and results revealed two tumour-related gene mutations (deletion of PMS2 and variation of ESR1 [L536P]). The patient did not receive any adjuvant therapy, and no signs of tumour progression were observed during the 6-month follow-up. CONCLUSION To the best of our knowledge, this study first presented about SFT arising from the IVC and carried out an NGS analysis to validate the molecular mechanism of such condition.
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Affiliation(s)
- Jingyuan Fan
- Department of Orthopedics and Traumatology Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021 People’s Republic of China
| | - Jinfeng Qiu
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021 People’s Republic of China
| | - Qingjun Wei
- Department of Orthopedics and Traumatology Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021 People’s Republic of China
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Yi X, Wang J, zhang Y, Wang Z, Zhang Z, Gong G, Liu L, Xiang W, Liao W, Zee C, Chen BT. Renal solitary fibrous tumor/hemangiopericytoma: computed tomography findings and clinicopathologic features. Abdom Radiol (NY) 2019; 44:642-651. [PMID: 30225611 DOI: 10.1007/s00261-018-1777-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To retrospectively characterize the clinical, pathological, and computed tomography (CT) findings of renal solitary fibrous tumor/hemangiopericytoma (rSFT/HPC). METHODS Twelve patients with rSFT/HPCs were enrolled. The CT findings and clinicopathological features were retrospectively reviewed. RESULTS This study included six male and six female patients (median age: 47; age range: 20-82 years). Eight benign (grade I) and four malignant (grade III) rSFT/HPCs were identified. Of the 12 lesions, 10 were in the renal sinus near the renal pelvis, while two replaced the whole kidney. Five lesions were well-defined, five were partially ill-defined, and two were ill-defined. Mild (5/12) and intermediate (1/12) hydronephrosis was observed. On the unenhanced CT images, ten tumors showed slightly higher density when compared to the normal renal parenchyma, and two masses were isodense to hypodense. After intravenous contrast medium injection, three enhancement patterns were observed, including "prolonged enhancement" (PE) (6/12), "gradual enhancement" (4/12), and "early washout" (2/12). A central fibrous scar was found in five patients. Compared to the grade I lesions, the grade III rSFT/HPC lesions tended to be larger (maximal diameter > 10 cm) and more heterogeneous with a higher incidence of the PE pattern. CONCLUSIONS We have shown that rSFT/HPCs usually arise from the renal sinus, and present as lobulated, slightly hyperdense, gradually enhancing soft tissue masses. CT findings, including large size, heterogeneity, and the PE pattern, may assist in the pre-operative identification of malignant grade III rSFT/HPCs.
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Hertz AM, Childers CK, Wingate JT, Perry JT, Kitley CA, Brand TC, Anderson MI. Malignant Solitary Fibrous Tumor of the Renal Vein Presenting as a Giant Renal Artery Aneurysm: A Case Report and Review of Literature. Int J Surg Pathol 2018; 27:72-76. [PMID: 29992862 DOI: 10.1177/1066896918787650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To discuss an unusual presentation of solitary fibrous tumor (SFT) as well as the first description of SFT originating from the renal vein. CASE REPORT In this article, we report the case of a 56-year-old man who presented with nonspecific epigastric pain and was found on computed tomography to have a large 10-cm renal artery aneurysm with evidence of contained rupture, segmental ischemia of the kidney, and suggestion of renal vein thrombosis. This was treated by a multidisciplinary team of urologists, vascular surgeons, and interventional radiologists with both renal artery coil embolization and radical nephrectomy. The thrombosis was found on pathologic review to be a malignant SFT originating from the renal vein with likely erosion into the renal artery. CONCLUSION This report describes the first case of SFT originating from the renal vein and demonstrates the potential for mimicry as a giant renal artery aneurysm.
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Rutkowski PL, Mullen JT. Management of the "Other" retroperitoneal sarcomas. J Surg Oncol 2017; 117:79-86. [PMID: 29127695 DOI: 10.1002/jso.24893] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/07/2017] [Indexed: 12/12/2022]
Abstract
The focus of this review is on the management of the less common sarcomas occurring in the retroperitoneal space, including solitary fibrous tumor (SFT), malignant peripheral nerve sheath tumor (MPNST), perivascular epithelioid cell tumor (PEComa), and undifferentiated pleomorphic sarcoma (UPS) of the psoas muscle. As for other retroperitoneal sarcomas, surgical resection is the mainstay of curative therapy, and multidisciplinary preoperative assessment, including percutaneous needle biopsy for histologic confirmation, is the basis for personalized management, as the surgical management, and the integration of systemic therapy and radiation therapy is unique to each histologic subtype.
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Affiliation(s)
- Piotr L Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - John T Mullen
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massacheusetts
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Solitary fibrous tumor of the abdominal wall re-surfacing as unilateral pleural effusion and mass: A case report and review of the literature. Respir Med Case Rep 2017; 23:4-7. [PMID: 29159031 PMCID: PMC5683803 DOI: 10.1016/j.rmcr.2017.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 12/11/2022] Open
Abstract
Background Solitary fibrous tumors (SFTs) are rare fibroblastic mesenchymal neoplasms that were initially described in the pleura, but have been increasingly recognized to occur in other parts of the body. They have been traditionally regarded as indolent tumors that are rare to metastasize after surgical resection. Here, we describe a case of a Filipino female who initially presented with unilateral pleural effusion and mass, and was ultimately diagnosed with recurrent solitary fibrous tumor that originated from the abdominal wall. Then, we reviewed existing literature on intra- and extrathoracic SFTs with focus on pathological characteristics, recommendations for treatment as well as post-treatment surveillance. Case presentation A 79-year-old Filipino female with a history of solitary fibrous tumor of the abdominal wall status post complete surgical resection 3 years ago presented with unilateral pleural effusion and mass, and was diagnosed with recurrent solitary fibrous tumor that metastasized to the lung. She was not a candidate for systemic chemotherapy and ultimately died 1 year later from progressive respiratory failure. Conclusions Solitary fibrous tumor are rare mesenchymal tumors that were initially described in the pleura, but have now been reported in many other sites. Complete surgical resection is the mainstay therapy for all cases; however, long-term monitoring and surveillance several years after initial presentation is crucial to prevent disease recurrence, and adjuvant treatment may be necessary for patients with high-risk features. Additional studies are needed to demonstrate the clinical utility of risk stratification models and to develop post-treatment surveillance guidelines for extrathoracic SFTs.
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