Solitary fibrous tumor of the liver: a case report

Superior Identification of Metastatic Lesions by 68 Ga-FAPI-46 PET/CT Than 18 F-FDG PET/CT in Hepatic Solitary Fibrous Tumor

ABSTRACT

Solitary fibrous tumors (SFTs) are fibroblast tumors that occur mainly in the pleura. Hepatic SFT with skeleton metastases was rarely documented. In this case, we report the contrast-enhanced CT, 18 F-FDG, and 68 Ga-FAPI-46 PET/CT findings of a rare hepatic SFT with bone metastases. 68 Ga-FAPI-46 PET/CT showed much higher tumor-to-background contrast of hepatic tumors and revealed more metastatic bone lesions than 18 F-FDG PET/CT. This case demonstrated the superiority of 68 Ga-FAPI-46 PET/CT over 18 F-FDG for identifying metastatic lesions in malignant SFTs. This observation may add information on the benefit of FAPI PET/CT in SFT staging.

Systemic metastasis in malignant solitary fibrous tumor of the liver: two case reports and literature review

Solitary fibrous tumor of the liver (SFTL) is an exceptionally rare mesenchymal tumor, with only 117 cases reported in the literature. While most SFTs are benign, some exhibit malignant behavior, including local recurrence and metastasis. This report presents two cases of SFTL with systemic metastases, both involving prior intracranial tumors. The first case, a 52-year-old woman, discovered a liver mass incidentally during a routine physical exam. Subsequent investigations revealed potential bone metastasis, and biopsy confirmed SFT. She received two TACE procedures, anlotinib targeted therapy, and radiotherapy for the iliac bone lesion, resulting in stable disease with reduction in lesion size. The second case, a 46-year-old man, presented with multiple liver, pelvic, and lung lesions following pelvic tumor resection, with pathology confirming SFT. He was treated with long-term anlotinib therapy, CyberKnife for hepatic, lung, and pelvic lesions, and radiofrequency ablation for hepatic lesions. Postoperative recovery was uneventful, with no tumor progression on follow-up. SFTL presents with atypical clinical and imaging features, and diagnosis requires pathological and genetic confirmation. Radical resection is preferred for solitary tumors, while comprehensive treatment, including surgery and long-term follow-up, is essential for cases with recurrence or metastasis.

Multidisciplinary collaboration for the successful treatment of a giant hepatic solitary fibrous tumor protruding into the thorax: A case report

Solitary fibrous tumors (SFTs) are composed of spindle cells and collagen fibers, and these form rare mesenchymal tumors. SFTs are most frequently observed in intrathoracic sites; however, they may also occur in extrathoracic sites, such as the liver. Unlike the hepatic SFTs (HSFTs) reported in the literature, the SFT detailed in the present case report was a large tumor that originated from the liver, with a dumbbell-shaped growth through the diaphragm into the right thoracic cavity. This posed substantial challenges in both diagnosis and treatment. Thus, the present report outlines the findings of a multidisciplinary team meeting that was used to discuss and develop an optimal and personalized treatment strategy for the patient. Transhepatic arterial embolization was performed to block the major arterial blood supply to the tumor in order to reduce its size. Subsequently, the tumor was fully resected, following the collaboration of the experienced hepatobiliary and thoracic surgeons. Following surgery, the abdominal distension experienced by the patient ceased, and no tumor recurrence was detected at the 1-year follow-up. In conclusion, due to limited previous reports of HSFT treatment using multidisciplinary collaboration, the present study outlined the treatment used for this specific tumor type, and the corresponding literature was reviewed.

Cellular solitary fibrous tumor in the mental area: a case report and literature review

Solitary fibrous tumors (SFTs) are rare benign mesenchymal tumors that occur mainly in the pleura. We herein report the first case of a cellular SFT located in the mental region of the head and neck in a 46-year-old woman. Facial computed tomography revealed a mass measuring 0.8 cm with clear boundaries in the right mental region. After excision of the mass, expert pathologists diagnosed a cellular SFT. To our knowledge, this is the first case of a cellular SFT identified in the subcutaneous tissue of the mental region of the head and neck. Because the postsurgical prognosis of SFTs is unpredictable, long-term follow-up and further studies are necessary to determine the characteristics of cellular SFTs in the head and neck region.

Giant solitary fibrous tumor of the pelvis: A case report and review of literature

INTRODUCTION

Solitary fibrous tumors (SFTs) are rare spindle cells neoplasms most likely arising from mesenchymal cells. Usually they involve the pleura. Even if extra-thoracic SFTs are rare, lately they are diagnosed with increased frequency.

CASE PRESENTATION

We describe the case of giant pelvic and retroperitoneal neoplasm, a rare solitary fibrous tumor, in a 51-year-old man that was admitted for abdominal pain.

DISCUSSION

On CT a SFT appears usually as a smooth, lobulated mass with occasional calcifications, but the imaging differential diagnosis with other mesenchymal tumors is very difficult, if not impossible.

CONCLUSION

The histological and immune-histochemical features of SFTs are helpful for the differential diagnosis. The malignant potential of this cancer is low, but it is very important to perform an optimized surgery and a close follow up in the patient. We believe that this case is particularly interesting and complex because of the difficulty of predicting the future biological behavior.

Malignant solitary fibrous tumor of the liver: a case report

INTRODUCTION

Solitary fibrous tumor (SFT) is a rare mesenchymal tumor. Due to the rarity of malignant solitary fibrous tumor of the liver, information regarding the disease is currently limited. We present herein a case of malignant liver SFT in a 17-year-old female, who was misdiagnosed with hepatoblastoma preoperatively.

CASE REPORT

A 17-year-old female who was diagnosed with hepatoblastoma preoperatively The patient presented with pain in the upper abdomen and an abdominal mass. Tumor markers were normal and imaging findings were atypical. The tumor was successfully removed by surgery. Postoperative pathological examination and immunohistochemistry confirmed malignant solitary fibrous tumor. The patient recovered uneventfully and is disease-free without recurrence at the time of this report (14 months post-surgery).

CONCLUSION

SFT originates in the liver and is a rare tumor. Differential diagnosis should be considered for liver lesions with atypical imaging findings. More data are needed to understand the disease's long-term outcome and identify clinical and radiologic features that can be useful for its diagnosis. The best choice for treatment is complete surgical resection, and definitive diagnosis based on histologic and immunohistochemical characteristics. Tumor biology is unclear, and long-term follow-up of SFT patients is critical.

Solitary fibrous tumor in the liver: case report and literature review

Background

Solitary fibrous tumors (SFTs) are uncommon mesenchymal neoplasms that present most commonly at intrathoracic sites. SFTs of the liver are rare, with only a few having been reported in the English-language literature. We report a rare case of a hepatic SFT and literature review.

Case presentation

A 49-year-old woman underwent surgery for a cranial hemangiopericytoma two decades previously. She currently presented with malaise. Abdominal computed tomography (CT) showed a huge, sharply demarcated mass in the anterior segment of the liver. Tumor marker levels were within the normal range. Following central bisegmentectomy of the liver, histological examination of the specimen revealed that the tumor was composed of spindle and fibroblast-like cells with collagenous stroma. Immunohistochemically, the spindle cells were negative for CD34 but positive for STAT6. The NAB2–STAT6 fusion gene was detected by the reverse transcription polymerase chain reaction. A diagnosis of SFT was thus confirmed histopathologically and genetically.

Conclusions

The SFT of the liver is an uncommon finding. Because there are no specific imaging features, it is difficult to diagnose the hepatic SFT preoperatively. We consider that careful surgical resection and postoperative follow-up are necessary for hepatic SFTs.

Ex situ hepatectomy and liver autotransplantation for a treating giant solitary fibrous tumor: A case report

A solitary fibrous tumor (SFT) is a rare mesenchymal tumor. Ex situ hepatectomy and liver autotransplantation are novel methods for the treatment of complicated liver tumors, for example, those involving vascular structures, including the inferior vena cava, which are unresectable by conventional approaches. The present study describes a rare case of a massive hepatic SFT in a 32-year-old female who underwent ex situ hepatectomy and liver autotransplantation to achieve a radical resection. The surgery was without complications. Post-operative histopathological and immunohistochemical examinations revealed an SFT of the liver. The patient was discharged 29 days after the surgery with fully recovered liver function. The routine check-up 3 months after surgery indicated normal liver function and no evidence of recurrence. Additionally, an exhaustive review of available literature was performed to provide a complete overview of the current status of SFTs. In summary, the present study found that ex situ hepatectomy and liver autotransplantation are suitable surgical techniques for treating a giant SFT, as well as other liver neoplasms that are considered unresectable by conventional surgery.

Solitary fibrous tumor of the liver - An unusual entity: A case report and review of literature

Solitary fibrous tumor (SFT) of the liver is a rare entity and its presentation is usually delayed till they grow to a substantial size. Clinico-radiological features are non-specific, contributing to increase in the diagnostic dilemma. Definitive diagnosis of SFT is usually made based on the histological features and immunohistochemistry data of the resected specimen. In this case report, we describe the case of an elderly male who presented with a large mass in the left lobe of the liver with normal level of tumor markers and atypical radiological findings. The patient successfully underwent resection of the tumor and the diagnosis was confirmed on histopathology.

Solitary fibrous tumour of the liver-report on metastasis and local recurrence of a malignant case and review of literature

Background

Solitary fibrous tumours (SFT) are neoplasms of mesenchymal origin that predominantly arise from the pleura. SFT of the liver (SFTL) are a rare occurrence with little number of cases reported in English literature. Malignant cases of hepatic SFT are an even rarer occurrence. For this reason, the prognostic evaluation of SFTLs is unknown and difficult to measure.

Methods

A search on English literature on “Solitary Fibrous Tumour of the Liver” was conducted on common search engines (PubMed, Google). All published articles, case reports and literature reviews and their reference lists were reviewed.

Case report

This paper presents a 61-year-old male who was referred to a tertiary hospital in April 2010 with marked hepatomegaly. USS, CT and MRI scans were suggestive of a neoplasm, and the patient underwent a subsegmental IVb resection in June 2010. The specimen demonstrated histological and immunohistochemical features of malignant SFTL with clear resection margins. The patient was followed up regularly for 3 years with imaging and no suggestion of recurrence. Six years after the initial surgery, the patient represented with worsening right upper quadrant pain and dyspnoea secondary to extensive tumour recurrence adjacent to the resection site and metastatic deposits in the pleura. The patient was managed symptomatically and discharged for community follow-up after palliative involvement.

Conclusions

SFTL are rare with only 84 cases reported in the English Literature including the present case. The average age of patients is 57.1 and occurs in females more than males (1.4:1). Most SFTLs follow a benign course, however, 17.9% of cases displayed malignant histological features. Only three cases including the current case are reported to have both local recurrence and metastasis. Surgical resection remains the mainstay of treatment and appears to be curative of most cases. The rarity of this tumour makes it difficult to evaluate its prognosis and natural course.

Solitary Fibrous Tumor of the Liver: a Review of the Current Knowledge and Report of a New Case

INTRODUCTION

Solitary fibrous tumors of the liver (SFTL) are uncommon tumors; to the present day, less than 50 cases has been reported in the English scientific literature, most of which behaved as benign tumors. The present article reports a new case of SFTL and has the main purpose of updating the current knowledge of SFTL because due to its rarity, its clinical presentation, study, treatment, and prognosis are not well known. The clinical presentation, radiologic study, surgical treatment, immunohistochemical study, and prognosis are updated and comprehensively discussed.

METHODS

Using the common search engines, a search of the English literature was conducted for "Solitary Fibrous Tumor of The Liver," and the relevant articles were retrieved, reviewed, and analyzed.

RESULTS

All published articles reported anecdotal SFTLs, or SFTLs were included in large series analyzing solitary fibrous tumors on different sites.

CONCLUSION

The SFTL is an uncommon neoplasm. The clinical presentation is habitually indolent and its behavior is uncertain. In some cases, the SFTL acts as an aggressive sarcoma with poor prognosis. Currently, only surgery offers a therapeutic opportunity for these patients. Due to the lack of current knowledge of long-term behavior of supposedly benign SFTLs and to the lack of specific therapies, methodical long-term follow-up is essential to ensure the survival of patients treated for SFTL.

An update on primary hepatic solitary fibrous tumor: An examination of the clinical and pathological features of four case studies and a literature review

BACKGROUND

Primary hepatic solitary fibrous tumor is a rare neoplasm that originates in the submesothelial tissue of the liver and is frequently misdiagnosed because of its rarity and unfamiliar characteristics.

AIM

To analyze, summarize and update the clinical and pathological features of primary hepatic solitary fibrous tumor.

METHODS

We systematically extract the clinical data of 4 cases from the relevant medical records, analyze the macroscopic, histological and immunohistochemical features and review the 59 previously reported cases in the English literatures.

RESULTS

The patients' mean age 50.75 years (range, 49-52 years), and the gender ratio was 1:1. The tumors ranged in size from 2.3 to 12.0cm (average diameter, 7.85cm). The tumors were composed of spindle cells with oval, fusiform or banded nuclei that were arranged in bundled, storiform or peculiar random patterns. Mitosis and hemangiopericytoma-like vessels were occasionally observed. Immunohistochemically, three cases were positive for Signal transduction and activator of transcription 6, cluster of differentiation 34, B-cell lymphoma-2 and vimentin but were negative for nervous, muscular and hepatocellular markers. Hepatic lobectomy was performed in all cases, and one patient received adjuvant chemotherapy simultaneously. One patient suffered two recurrences without metastasis, and the remaining patients experienced favorable outcomes.

CONCLUSIONS

A consensus on the essential and definite diagnostic criteria for primary hepatic solitary fibrous tumor must be reached in a timely manner. Signal transduction and activator of transcription 6 is a highly sensitive and specific immunohistochemical marker for primary hepatic solitary fibrous tumor.

Solitary fibrous tumor located in the sella turcica: A report of two cases and review of the literature

Solitary fibrous tumors (SFTs) of the sella turcica are rare entities, with only four cases reported in the literature thus far. The current study describes two cases of SFT arising from the sella turcica, including presentation of the clinical, imaging and histopathological findings, and the initial treatment strategies and diagnosis, with emphasis on the treatment of the tumor in this unusual location. Magnetic resonance imaging is a useful method for identifying a solid or heterogeneous mass; however, histopathological and immunohistochemical data are required to clarify such diagnoses. The majority of SFTs exhibit clinically benign behavior and have a positive outcome; however, certain SFTs may present malignant features. Although gross total resection of SFTs in the sella turcica is important, subtotal resection with subsequent stereotactic radiotherapy is proposed as an acceptable alternative. Furthermore, careful and long-term follow-up of patients with SFT of the sella turcica is required as the clinical outcome is unpredictable.

(18)F-FDG PET/CT imaging of malignant hepatic solitary fibrous tumor

Solitary fibrous tumor of the liver was rarely documented. F-FDG PET/CT imaging of malignant hepatic solitary fibrous tumor in a 49-year-old male patient was reported. The multifocal hepatic lesions demonstrated avid FDG uptake. FDG PET/CT might be potentially useful in the differentiation of benign and malignant solitary fibrous tumor.

Malignant solitary fibrous tumor involving the liver

Solitary fibrous tumors are predominantly benign and are most commonly found in the thoracic cavity and pleura; while reports exist in the literature of malignant solitary fibrous tumors and those located in extrathoracic organs, these cases are considered extremely rare. Herein, a case is reported of a malignant solitary fibrous tumor involving the liver that was diagnosed and treated in a 62-year-old woman. The patient presented with complaints of upper abdominal pain and unintentional weight loss. Computed tomography scan of the abdomen revealed a remarkably large mass, measuring 15 cm × 10 cm × 20 cm, which appeared to be unrelated to any particular organ. The intraoperative finding of a wide communication with the left liver suggested hepatic origin, and served as an indicator for tumor resection via left hemihepatectomy. The diagnosis of solitary fibrous tumor and its malignant nature was confirmed by histological and immunohistochemical examination of the resected tissues. Hepatic solitary fibrous tumor is very rare, and surgery remains the mainstay of treatment. Due to limited reports of such tumors in the literature, little can be said about the benefit of adjuvant therapy and prognosis for the rare cases with malignant histological findings.