Primary myxoid solitary fibrous tumor involving the seminal vesicle

Solitary Fibrous Tumor of the Seminal Vesicle: A Systematic Literature Review and Case Presentation

BACKGROUND/AIM

Solitary fibrous tumors (SFTs) are ubiquitous mesenchymal neoplasms that have an unpredictable biological behavior. Histological criteria for this type of malignancy are uncertain. Clinical characteristics, diagnostic and treatment options of SFTs originating in the seminal vesicle are presented in this review article.

MATERIALS AND METHODS

A systematic review including the following databases: Scopus, Embase and Medline from 1960 until the end of March 2021 was performed according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines.

RESULTS

We found seven patients affected with SFTs of seminal vesicle, in which we added our own case, making a total of 8 patients. Mean age at presentation was 55±7 years. Mean size of the SFTs was 9±2 cm and the right seminal vesicle was preferentially involved. The majority of patients were symptomatic and presenting symptoms were hematuria, dysuria, hematospermia, urinary increased frequency and urgency. Abdominal ultrasonography, computed tomography (CT) scan, and magnetic resonance (MRI) were the diagnostic tools. Trans-rectal ultrasound-guided core biopsy was also used. Seven (87%) patients had open surgery. Adjuvant radiotherapy after R0 resection was used in 1 patient.

CONCLUSION

The treatment of SFTs located in the seminal vesicle necessitates a radical surgical resection to obtain acceptable results in terms of local recurrence and distant metastases.

Cervical Myxoid Solitary Fibrous Tumor: Report of an Unusual Variant and a Brief Overview of the Literature

We present a 49 year old female with a diagnostically challenging myxoid solitary fibrous tumor arising in the soft tissue of the neck. The tumor was diffusely positive for CD34 and STAT6 on immunohistochemistry.

Solitary fibrous tumor of the seminal vesicle: A case report

RATIONALE

Solitary fibrous tumor (SFT) is an unusual neoplasm, especially when it originates from the seminal vesicle. Herein, we describe a case of SFT that arises from the seminal vesicle.

PATIENT CONCERNS

A 66-year-old man presented to our hospital complaining of a huge irregular tumor in his pelvis during a health checkup. He was worried that the tumor could be a malignant tumor and hence wanted to undergo further examination and therapy.

DIAGNOSIS

An inhomogeneous, mixed soft tissue tumor in the pelvis was found during computed tomography (CT) and magnetic resonance imaging. The tumor showed heterogeneous and delayed enhancement during contrast-enhanced CT. The tumor was diagnosed as a cystadenoma originated from the seminal vesicle due to its imaging features. But the pathological diagnosis was SFT that originated from the seminal vesicle.

INTERVENTIONS

Laparoscopic seminal vesicle tumor resection was performed.

OUTCOMES

There was no evidence of recurrence at the 6-month follow-up.

LESSONS

SFT in the seminal vesicle is extremely rare. It is very difficult to distinguish SFT in the seminal vesicle from the primary tumors as both have similar imaging features. We describe the tumor with SFT being considered as a differential diagnosis when the tumor is found in the seminal vesicle.

Myxoid solitary fibrous tumor: a study of three cases

Limited myxoid areas are usually encountered in solitary fibrous tumor (SFT), but SFT with abundant myxoid stroma has only been reported occasionally. Myxoid SFT is defined as having myxoid changes in 50% or more of the tumor. We review the literature on myxoid SFT and add 3 new cases to those previously described. Microscopically, the lesions were composed of spindle cells arranged in a haphazard or storiform pattern in a cellular and hypocellular myxoid background with thin-walled "staghorn" branching vessels. Atypical features (necrosis, hypercellularity, or increased mitotic figures) were not identified. All cases were positive for CD34 and CD99 and had a benign course with a follow-up ranging from 15 to 70 months. Our review suggests that like classical SFT, myxoid SFT is associated with an indolent clinical course and favorable prognosis. Their recognition is crucial to distinguish a variety of myxoid spindle cell neoplasms with different prognoses and treatment options.

Radiology-pathology conference: malignant solitary fibrous tumor of the seminal vesicle

Mesenchymal neoplasms are rarely encountered in the seminal vesicle. Only four cases of the seminal vesicle solitary fibrous tumor have been reported in English literature, all of which were benign in nature. We are describing the clinicoradiological and pathological features of a locally aggressive malignant solitary fibrous tumor arising from the seminal vesicle, which posed the therapeutic challenge for the surgical management in a 52-year-old male patient. To our knowledge, this is the first reported case of the malignant solitary fibrous tumor arising from the seminal vesicle.

Somatic and visceral solitary fibrous tumors in the abdomen and pelvis: cross-sectional imaging spectrum

Solitary fibrous tumors (SFTs) are a unique group of mesenchymal neoplasms of fibroblastic or myofibroblastic origin. These tumors were originally described as "benign fibrous mesotheliomas" of the pleural cavity and were erroneously thought to be confined to the serosal surfaces (due to a putative mesothelial or submesothelial origin). It is now established that SFTs are ubiquitous neoplasms with both pleural and extrapleural distribution. Extrapleural SFTs commonly occur in middle-aged adults and manifest as asymptomatic, slow-growing, large tumors. Fewer than 5% of patients with SFTs present with symptomatic hypoglycemia. SFTs are histopathologically diverse with a variable admixture of fibroblasts or myofibroblasts, numerous thin-walled vessels, and dense fibrosis. Tumors previously categorized as hemangiopericytomas are now considered cellular variants of SFTs. At imaging, SFTs demonstrate remarkable heterogeneity, with variable degrees of enhancement, necrosis, or hemorrhage. Although most extrapleural SFTs have a benign clinical course, 10%-15% of these tumors demonstrate aggressive behavior in the form of recurrence or malignancy.

Myxoid solitary fibrous tumor of the retroperitoneum: MRI findings with the pathologic correlation

We report here on a case of solitary fibrous tumor of the retroperitoneum, and the tumor displayed a predominantly myxoid histology. A 56-year-old man presented with an incidentally detected retroperitoneal mass. On the MR images, the mass was observed as having iso-signal intensity on the T1-weighted images and high signal intensity on the fat-saturated T2-weighted images. The mass showed intense enhancement on the Gd-DTPA enhanced T1-weighted images. At surgery, a well-defined solid mass was found in the left retroperitoneum. The histological diagnosis was made as solitary fibrous tumor with a predominantly myxoid histology.