Solitary fibrous tumour of the uterus

Risk Assessment in Solitary Fibrous Tumor of the Uterine Corpus: Report of a Case and Systematic Review of the Literature

Solitary fibrous tumor (SFT) is an uncommon fibroblastic tumor occurring preferentially in the pleura, with a variable clinical course. SFT can arise also in numerous extrathoracic sites and very rarely in the female genital tract, with only scarce reports of uterine SFT. We reported a new uterine SFT arising in a 45-year-old woman, and we performed a systematic review of SFT cases of the uterine corpus interrogating the electronic databases PubMed, Web of Science, and Scopus. We identified only 13 patients diagnosed with SFT of the uterine corpus, including our one. Complete clinical workout at disease presentation showed no evidence of extrauterine spread in all cases, except for 1 patient who presented with metastatic disease. Tumor recurrences/metastases occurred in a minority of the patients and were poorly related to clinicopathological risk factors and patients stratification based on different scoring systems. Since the long-term clinical behavior of uterine SFT is limited and poorly predictable, extended follow-up is recommended also for all cases arising in the uterine corpus.

A broad ligament solitary fibrous tumor with Doege-Potter syndrome

INTRODUCTION

Solitary fibrous tumors (SFTs) are uncommon mesenchymal neoplasms and are particularly rare in the female genital tract. Doege-Potter syndrome is a paraneoplastic syndrome involving SFT-associated hypoglycemia. We report, for the first time, on a broad ligament SFT with Doege-Potter syndrome; additionally, we review 30 cases of women with SFTs reported in the literature.

PATIENT CONCERNS

A 37-year-old woman who presented with life-threatening hypoglycemia and a pelvic mass (16 × 15 × 15 cm).

DIAGNOSES

The patient was diagnosed with broad ligament SFT with Doege-Potter syndrome.

INTERVENTIONS

Tumor resection, sub-extensive hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed, and 6 cycles of adjuvant chemotherapy were administered.

OUTCOMES

Serum glucose levels returned to normal as soon as the tumor was resected. Forty-3 months after operation, there was recurrence in the posterior peritoneal tissues. She underwent tumor resection and has remained tumor-free 28 months after this excision.

CONCLUSION

Even though it is extremely rare, SFT should be quickly identified to prevent undue treatment delay and avoid unnecessary examination; surgery and long-term follow-up are recommended. SFT can be considered a highly invasive cancer, and intraoperative bleeding may occur. Although no correlation between adjuvant therapy and improved prognosis was found, further studies are required because of the small number of cases reported to date.

Solitary Fibrous Tumor of the Vagina

Solitary fibrous tumor, initially described in the pleura, is now known to occur in various extrathoracic sites. However, its occurrence in the female genital tract, especially the vagina, is extremely rare. The authors report here a case of a well-circumscribed vaginal spindle cell nodule in a 48-year-old woman with features consistent with solitary fibrous tumor. The diagnosis was established histologically by the varying pattern with hypocellular fibrous areas alternating with hypercellular areas and hemangiopericytoma-like areas and, immunohistochemically by the strong positive reaction for CD34 and Bcl2 with a negative reaction for all other spindle cell and epithelial markers. The differential diagnosis is discussed and a review of the literature is presented.

A leiomyomatoid angiomatous neuroendocrine tumor of the myometrium: case study with ultrastructural analysis

Leiomyomatoid angiomatous neuroendocrine tumor (LANT) is a possible new disease entity that was described as a dimorphic neurosecretory tumor with a leiomyomatous vascular component; it was found in the pituitary. We describe here a second case of LANT in a 45-year-old woman with a myometrial tumor, diagnosed clinically as uterine leiomyoma. She underwent laparoscopic myomectomy. The tumor consisted of hyalinized vasculature, containing factor VIII-positive endothelium and smooth muscle actin-positive vascular smooth muscle cells, and stromal cells, expressing neuroadhesion molecules. Both vascular and stromal components diffusely expressed chromogranin A and, as evidenced by electron microscopy, possessed smooth muscle actin filaments and electron-dense neurosecretory granules, which contained the neurosecretory hormone somatostatin. Although no cytokeratin-positive cells were observed, some tumor cells had positive Grimelius staining for argyrophilic granules. These findings meet the definition of LANT, and the occurrence of our case suggests that LANT is a special type of neuroendocrine neoplasm and is not organ specific.

A solitary fibrous tumor in the broad ligament of the uterus

Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that occurs preferentially in the pleura. Although it has been described at some extrathoracic sites, its occurrence in the female genital tract is extremely rare. We are the first to report on an unusual case of a large (14cm in the largest diameter) SFT localized in the broad ligament of the uterus in a 50-year-old woman. The patient underwent surgical tumor extirpation and has remained well without any sign of local tumor recurrence after 6 years of follow-up. We discuss the clinical aspects, the gross macroscopic appearance, the histologic findings, and the differential diagnosis, and provide a review of the literature.