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Liu M, Zheng C, Wang J, Wang JX, He L. Solitary fibrous tumor of the renal pelvis: A case report. World J Clin Cases 2022; 10:9798-9804. [PMID: 36186182 PMCID: PMC9516909 DOI: 10.12998/wjcc.v10.i27.9798] [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: 04/06/2022] [Revised: 06/12/2022] [Accepted: 08/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm. SFT derived from the renal pelvis is an exceedingly rare entity. In this study, we report a case of renal pelvis SFT and review the relevant literature on this rare tumor.
CASE SUMMARY A 76-year-old man was hospitalized due to right lumbar and abdominal pain. Abdominal computed tomography showed a hypervascular space-occupying renal lesion, sized 2.3 cm × 1.8 cm. Based on the computed tomography findings, the patient was diagnosed with right renal pelvis tumor and underwent nephrectomy. Postoperative immunohistochemical results confirmed the diagnosis. As of the 3-year follow-up, there were no signs of recurrence, and the patient has recovered well.
CONCLUSION We report a rare case of SFT derived from the renal pelvis and discuss the imaging and histopathological features that distinguish renal pelvis SFT from other renal pelvis tumors.
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Affiliation(s)
- Min Liu
- Department of Urology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Chao Zheng
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Jin Wang
- Department of Urology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Ji-Xue Wang
- Department of Urology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Liang He
- Department of Urology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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BCOR Overexpression in Renal Malignant Solitary Fibrous Tumors: A Close Mimic of Clear Cell Sarcoma of Kidney. Am J Surg Pathol 2020; 43:773-782. [PMID: 30864973 DOI: 10.1097/pas.0000000000001243] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BCOR immunoreactivity is a sensitive and highly specific marker for clear cell sarcoma of the kidney (CCSK). However, a subset of adult renal sarcomas which overexpress BCOR are negative for BCOR genetic alterations, including BCOR gene fusions or BCOR-internal tandem duplication, and thus remain unclassified. We report 5 such undifferentiated renal/perirenal sarcomas which raised the differential diagnosis of CCSK due to their morphologic appearance and strong BCOR immunoreactivity, but which on RNA sequencing proved to be malignant solitary fibrous tumors (SFTs). The neoplasms occurred in patients at an age range of 30 to 62 years. Three patients were females and 2 male. Four were primary renal neoplasms while one was perirenal. All 5 neoplasms were cellular, nonpleomorphic, undifferentiated sarcomas with branching capillary vasculature composed of primitive round to ovoid neoplastic cells with scant cytoplasm and nuclei having fine, evenly dispersed chromatin. None of the cases demonstrated the typical hyperchromatic fusiform nuclei, prominent collagen deposition, or hemangiopericytomatous vasculature of SFT. All 5 cases were strongly immunoreactive for BCOR. Three cases were CD34 negative, where the other 2 were only focally CD34 positive. STAT6 was subsequently found to be positive by immunohistochemistry in all 5 cases. In summary, we report a previously unrecognized mimic of CCSK: malignant SFTs with an undifferentiated/small round cell phenotype along with branching capillary vasculature, strong immunoreactivity for BCOR, and minimal or no immunoreactivity for CD34. As CCSK is treated with a specific chemotherapy regimen, this distinction has therapeutic implications.
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Yang H, Zhang Y, Zheng T, Li C, Tang G, Chen G. A solitary fibrous tumor/hemangiopericytoma of the fourth ventricle: case report and literature review. J Int Med Res 2019; 47:6349-6355. [PMID: 31736390 PMCID: PMC7045656 DOI: 10.1177/0300060519885567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Solitary fibrous tumors/hemangiopericytomas (SFTs/HPCs) are rare in the central nervous system and intraventricular SFTs/HPCs are even rarer. We present a clinical case of SFT/HPC that was located in the fourth ventricle and performed a literature review of radiological findings of SFT/HPC. The patient was a 52-year-old man who presented to our hospital with dizziness and progressive weakness in his left extremities. Computed tomography and magnetic resonance imaging showed an irregular-shaped mass in the fourth ventricle. The upper anterior and lower posterior parts of the mass showed different densities and signal intensities, which formed a black and white sign. The upper anterior and lower posterior parts of the mass were enhanced to different degrees, and showed heterogeneous reversed enhancement. The patient underwent surgical resection and the mass was histologically confirmed to be an SFT/HPC. SFTs/HPCs of the fourth ventricle are rare, but show characteristic radiological presentations. In the present case, we observed a solid mass with flow voids, black and white sign, and heterogeneously reversed enhancement in the fourth ventricle. Collectively, these radiological features suggested the diagnosis of SFT/HPC.
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Affiliation(s)
- Han Yang
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yuxin Zhang
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ting Zheng
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Cao Li
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Guangcai Tang
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Guangxiang Chen
- The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Malignant Renal Solitary Fibrous Tumor With Two Local Recurrences and Distant Pulmonary Metastasis. Urology 2019; 127:9-12. [PMID: 30742864 DOI: 10.1016/j.urology.2019.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/20/2019] [Accepted: 01/29/2019] [Indexed: 11/21/2022]
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Zhang Q, Qin J, Li Y, Wu T. Primary solitary fibrous tumor of kidney: A case report and literature review. Urol Case Rep 2019; 23:92-94. [PMID: 30719410 PMCID: PMC6350095 DOI: 10.1016/j.eucr.2019.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 01/21/2023] Open
Abstract
Primary solitary fibrous tumors of kidney are rare in clinical practice. In literature, only eleven reported cases originated from renal pelvis. We report a case of a 45 year old middle-aged woman who was the first report that a small number of heterosexual cells have been found in urine. Definite diagnosis of this disease still depends on pathological examination, If preoperative puncture or other pathological examination supports the diagnosis of SFTs, the preferred treatment plan for it is surgical resection.
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Affiliation(s)
- Qiang Zhang
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiao Qin
- Operation Room, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yugen Li
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Tao Wu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Solitary Fibrous Tumor of the Kidney Developing Local Recurrence. Case Rep Urol 2016; 2016:2426874. [PMID: 27239363 PMCID: PMC4864535 DOI: 10.1155/2016/2426874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/30/2016] [Accepted: 04/07/2016] [Indexed: 12/20/2022] Open
Abstract
Solitary fibrous tumor (SFT) of the kidney is a rare entity and usually displays a favorable prognosis. We herein report a second case of renal SFT developing local recurrence. A 50-year-old man was referred to our hospital because of a left renal mass. An abdominal CT detected a large renal tumor and radical nephrectomy was performed with a possible diagnosis of renal cell carcinoma. The resected tumor size was measured at 17 × 11 × 8 cm. Grossly, necrosis was observed in central lesion of the tumor but hemorrhage was not observed. Microscopically, the tumor consisted of spindle-shaped cells with scant cytoplasm accompanied by hyalinized collagenous tissue, which displayed hemangiopericytomatous patterns. The cellularity was normal and nuclear pleomorphism was not observed. Ki-67 labeling index was less than 3%. The pathological diagnosis of SFT was made without obvious malignant findings. Three years after the surgery, a follow-up CT scan detected a mass lesion in the tumor bed. Surgical resection was performed and the resected tumor was compatible with local recurrence of the SFT without obvious malignant findings. Renal SFT should be carefully monitored even in the absence of obvious malignant findings.
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Outcome of surgery in patients with solitary fibrous tumors of the pleura. Asian Cardiovasc Thorac Ann 2015; 24:18-22. [DOI: 10.1177/0218492315614977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Solitary fibrous tumor of the pleura is rare, and the origin is submesothelial tissue. These tumors are seen in lung infrequently, and most are benign. We report our experience in the diagnosis and treatment of patients with solitary fibrous tumors of the pleura. Methods We studied 13 patients (6 men and 7 women, aged 26 to 76 years) with a diagnosis of benign solitary fibrous tumor of the pleura who were operated on from 2001 to 2014. One had a recurrent tumor after 10 years, and the others had primary tumors. Our approach was complete resection in all cases. Results After surgical excision, the most essential characteristic on histopathology was a neoplastic lesion composed of spindle-shaped tumor cells with hyperchromatic nuclei and eosinophilic bands of collagen. On immunohistochemical analysis, the cells were positive for desmin and negative for actin, synaptophysin, chromogranin, and CD117. Conclusions The essential step in the treatment of a patient with a diagnosis of benign solitary fibrous tumor of the pleura is complete resection. These patients should be followed up for a long time because of the possibility of late recurrence. Due to the rarity of these tumors, there has been no systematic assessment of the role of adjuvant therapy for benign solitary fibrous tumor of the pleura.
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Metachronous Malignant Solitary Fibrous Tumor of Kidney: Case Report and Review of Literature. Urol Case Rep 2015; 4:45-7. [PMID: 26793578 PMCID: PMC4719796 DOI: 10.1016/j.eucr.2015.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 09/19/2015] [Accepted: 09/23/2015] [Indexed: 11/23/2022] Open
Abstract
Solitary fibrous tumors are well described in the pleura, but rare extra-pleural neoplasms have been reported. We describe a patient with a solitary left renal fibrous tumor who after undergoing a nephrectomy, presented 8 years later with a contralateral metachronous solitary fibrous tumor. Malignant metastatic extra-pleural solitary fibrous tumors are extremely rare, and to our knowledge, this is the first case of contralateral recurrence of solitary renal fibrous tumor. The patient underwent a robotic assisted partial nephrectomy of the right renal mass. Both tumors showed overlapping histopathology.
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Ichiyanagi O, Ito H, Takai S, Naito S, Kato T, Nagaoka A, Yamakawa M. A GRIA2 and PAX8-positive renal solitary fibrous tumor with NAB2-STAT6 gene fusion. Diagn Pathol 2015; 10:155. [PMID: 26337721 PMCID: PMC4559176 DOI: 10.1186/s13000-015-0386-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/25/2015] [Indexed: 01/20/2023] Open
Abstract
Solitary fibrous tumor (SFT) is a rare neoplasm composed of mesenchymal-derived spindle cells. Although SFT occurs anywhere in the body, they most frequently affects the thoracic region. Here, we reported an extremely rare case of an extrathoracic SFT occurring primarily in the kidney. To our knowledge, little information has been described on the immunohistochemistry (IHC) and genetics of renal SFT. A 41-year old Japanese female came to our hospital for further examination of a left kidney mass detected incidentally with ultrasound. Extensive investigation of the tumor, including physical, laboratory, and image examinations led to a clinical diagnosis of renal cancer (cT1aN0M0), which were in most parts imbedded in the lower polar parenchyma. The patient underwent laparoscopic radical nephrectomy. The mass was diagnosed pathologically as SFT originating from the kidney, but not as renal carcinoma. Microscopically, the tumor was composed of spindle-shape cells distributed variably in dense collagenous stroma and had a focal hemangiopericytomatous staghorn-like vascular pattern. Mitotic figures, atypical structures, necrosis and hemorrhage were not identified. No adjuvant therapies were given postoperatively. The patient has been free of tumor recurrence for 25 months since the surgery. IHC revealed that the tumor diffusely expressed CD34, CD99, Bcl2, PAX8, NAB2, STAT6, and GRIA2. The tumor stained negatively for desmin, S-100, c-Kit, CK-AE1/AE3, CDK4 and MDM2. A NAB2-SATA6 gene fusion was detected in tumor cells by reverse transcription-polymerase chain reaction, direct sequencing, and an in situ proximity ligation brightfield assay. The gene fusion occurred as an 831 bp truncation of exon 2 in NAB2 connected to the beginning of exon 3 in STAT6. We have reported a case of GRIA2 and PAX8-positive SFT occurring primarily in the kidney with such NAB2-STAT6 gene fusion for the first time. Diffuse expression of PAX8 in the tumor might present with a renal origin. Reportedly, benign histology of SFT cannot necessarily predict favorable clinical prognosis. Genetic alterations recently identified in SFT could possibly refer to risk stratification for tumor recurrence. However, malignant preponderance of extrathoracic SFT over thoracic SFT remains unexplained so far. Long-term follow-up after surgery should be performed in the present case.
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Affiliation(s)
- Osamu Ichiyanagi
- Department of Urology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata City, Yamagata prefecture, 990-9585, Japan.
| | - Hiromi Ito
- Department of Urology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata City, Yamagata prefecture, 990-9585, Japan.
| | - Satoshi Takai
- Department of Urology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata City, Yamagata prefecture, 990-9585, Japan.
| | - Sei Naito
- Department of Urology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata City, Yamagata prefecture, 990-9585, Japan.
| | - Tomoyuki Kato
- Department of Urology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata City, Yamagata prefecture, 990-9585, Japan.
| | - Akira Nagaoka
- Department of Urology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata City, Yamagata prefecture, 990-9585, Japan.
| | - Mitsunori Yamakawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata City, Yamagata prefecture, 990-9585, Japan.
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Kuroda N, Ohe C, Sakaida N, Uemura Y, Inoue K, Nagashima Y, Hes O, Michal M. Solitary fibrous tumor of the kidney with focus on clinical and pathobiological aspects. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:2737-2742. [PMID: 25031693 PMCID: PMC4097243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 05/28/2014] [Indexed: 06/03/2023]
Abstract
Renal solitary fibrous tumor (SFT) is a rare, and a large scale study on this topic is lacking to date. In this article, we summarize the previously reported cases. The symptoms and signs resemble those of renal cell carcinoma, including hematuria, flank/abdominal/lumbar pain and palpable abdominal mass. Grossly, the tumor demonstrates a well-circumscribed solid mass. Microscopically, the tumor consists of fusiform or ovoid spindle cells and a various amounts of collagen bundles with patternless, storiform, or fascicular arrangements with an occasional hemangiopericytomatous pattern. Immunohistochemically, CD34, CD99 and bcl-2 are often detected. Ultrastructurally, tumor cells contain irregular nuclei, prominent Golgi apparatus, branching rough endoplasmic reticulum, variable numbers of mitochondria. Surgical resection is considered to be the gold standard therapy. Most of renal SFT are benign, but cases of approximately 10 to 15% behave in an aggressive fashion. All patients need to be on long-term follow-up because clinical behavior is rather unpredictable. As the molecular genetic study of renal SFTs is lacking, a large scale study will be desirable in the future.
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Affiliation(s)
- Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross HospitalKochi, Japan
| | - Chisato Ohe
- Department of Pathology, Kansai Medical University Hirakata HospitalOsaka, Japan
| | - Noriko Sakaida
- Department of Pathology, Kansai Medical University Hirakata HospitalOsaka, Japan
| | - Yoshiko Uemura
- Department of Pathology, Kansai Medical University Hirakata HospitalOsaka, Japan
| | - Keiji Inoue
- Department of Urology, Kochi Medical School, Kochi UniversityKochi, Japan
| | - Yoji Nagashima
- Division of Diagnostic Pathology, Tokyo Women’s Medical University HospitalTokyo, Japan
| | - Ondrej Hes
- Department of Pathology, Charles University in Prague, Faculty of Medicine in PlzenCzech Republic
| | - Michal Michal
- Department of Pathology, Charles University in Prague, Faculty of Medicine in PlzenCzech Republic
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Kamath SM, Nagaraj HK, Mysorekar VV, Patil GV, Gowri M. Solitary fibrous tumour of the kidney: case report with review of the literature. J Clin Diagn Res 2013; 7:2968-9. [PMID: 24551694 PMCID: PMC3919405 DOI: 10.7860/jcdr/2013/7074.3811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 10/26/2013] [Indexed: 11/24/2022]
Abstract
Solitary Fibrous Tumour (SFT) is an unusual spindle cell tumour that usually occurs in the pleura, but has recently also been reported to be extra-pleural in origin. A renal presentation is very rare. Upto 90% of the tumours have benign characteristics. It is difficult to differentiate it from renal cell carcinoma by using imaging techniques. A definitive diagnosis can be made by doing a detailed pathological examination, which includes immunohistochemistry. We are reporting a case of a large solitary fibrous tumour of the kidney which here occurred in a 70-years-old male. Histological examination of the resected specimen confirmed the diagnosis, by revealing strongly positive reactions of the neoplastic cells for CD34, bcl-2, vimentin and negativity for Epithelial Membrane Antigen (EMA), Smooth Muscle Actin (SMA), S-100 protein and Ki-67. The patient suffered a cardiac arrest and died on the seventh day after his surgery.
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Affiliation(s)
| | - HK Nagaraj
- Senior Professor, Department of Urology, M S Ramaiah Medical College & Teaching Hospital, India
| | - Vijaya V Mysorekar
- Senior Professor, Department of Pathology, M S Ramaiah Medical College & Teaching Hospital, India
| | - Geeta V Patil
- Assistant Professor, Department of Pathology, M S Ramaiah Medical College & Teaching Hospital, India
| | - Mangala Gowri
- Professor, Department of Pathology, M S Ramaiah Medical College & Teaching Hospital, India
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Olson MT, Wakely PE, Ali SZ. Metastases to the pancreas diagnosed by fine-needle aspiration. Acta Cytol 2013; 57:473-80. [PMID: 24021904 DOI: 10.1159/000352006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 05/06/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND Metastatic cancer infrequently involves the pancreas. When the pancreas hosts a metastatic tumor, cytopathological evaluation of fine-needle aspirate material is a crucial part of the diagnostic process. In this study, we show two institutions' experience with cytopathological diagnosis of pancreatic metastasis. METHODS Databases of institutional experience at The Johns Hopkins Hospital and Ohio State University Medical Center were queried for cases of metastatic tumors in the pancreas that underwent fine-needle aspiration. Demographic and pathological features were compiled and the cytomorphology was reviewed. RESULTS Forty-two cases of tumor metastasis to the pancreas were found. Over the time of this review, 5,495 aspirates were performed, and 43% (2,389/5,495) had malignant cytological findings. Thus, the 42 cases of metastatic disease to the pancreas comprised 0.8% of all pancreas aspirates and 1.8% of the malignant ones. Renal cell carcinoma was the most common metastasis, followed by melanoma and non-small cell lung carcinoma. Among the other tumors in this series, 2 cases each of rare metastases such as the fibrolamellar variant of hepatocellular carcinoma and solitary fibrous tumor were also seen. CONCLUSION The pancreas is rarely involved with metastatic disease, but when it is involved the most common tumor is renal cell carcinoma followed by melanoma and non-small cell lung cancer. Clinical history and awareness of the primary pancreatic mimickers are necessary for arriving at the correct diagnosis. As conventional pancreatic adenocarcinoma is uncommon in children and young adults, history of other tumors - even ones that usually follow an indolent course - is essential.
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Affiliation(s)
- Matthew T Olson
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Md., USA
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Abstract
Solitary fibrous tumors (SFTs) are unusual spindle cell neoplasms initially described in the pleura but have since been discovered in many extrapleural locations. SFT of the kidney is extremely rare, the majority occurring in middle-aged adults. To date, only two pediatric cases of renal SFT have been reported. We report a case of large SFT in the kidney of a 3-year-old boy that was clinically and radiologically thought to be a nephroblastoma. This case is the first pediatric renal SFT to be reported with detailed histopathologic and cytogenetic analyses. SFT should be included in the differential diagnosis of pediatric renal tumors.
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Affiliation(s)
- William W. Wu
- University of California Irvine Medical Center, Orange, CA, USA
| | - Julia T. Chu
- University of California Irvine Medical Center, Orange, CA, USA
| | | | - Lisa Shane
- Long Beach Memorial Medical Center, Long Beach, CA, USA
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