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Ren C, D'Amato G, Hornicek FJ, Tao H, Duan Z. Advances in the molecular biology of the solitary fibrous tumor and potential impact on clinical applications. Cancer Metastasis Rev 2024:10.1007/s10555-024-10204-8. [PMID: 39120790 DOI: 10.1007/s10555-024-10204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal neoplasm. The current classification has merged SFT and hemangiopericytoma (HPC) into the same tumor entity, while the risk stratification models have been developed to compensate for clinical prediction. Typically, slow-growing and asymptomatic, SFT can occur in various anatomical sites, most commonly in the pleura. Histologically, SFT consists of spindle to oval cells with minimal patterned growth, surrounded by stromal collagen and unique vascular patterns. Molecularly, SFT is defined by the fusion of NGFI-A-binding protein 2 (NAB2) and signal transducer and activator of transcription 6 (STAT6) genes as NAB2-STAT6. This fusion transforms NAB2 into a transcriptional activator, activating early growth response 1 (EGR1) and contributing to SFT pathogenesis and development. There are several fusion variants of NAB2-STAT6 in tumor tissues, with the most frequent ones being NAB2ex4-STAT6ex2 and NAB2ex6-STAT6ex16/ex17. Diagnostic methods play a crucial role in SFT clinical practice and basic research, including RT-PCR, next-generation sequencing (NGS), FISH, immunohistochemistry (IHC), and Western blot analysis, each with distinct capabilities and limitations. Traditional treatment strategies of SFT encompass surgical resection, radiation therapy, and chemotherapy, while emerging management regimes include antiangiogenic agents, immunotherapy, RNA-targeting technologies, and potential targeted drugs. This review provides an update on SFT's clinical and molecular aspects, diagnostic methods, and potential therapies.
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Affiliation(s)
- Chongmin Ren
- Department of Bone Tumor, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266101, Shandong, China
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Papanicolaou Cancer Research Building, 1550 NW. 10Th Avenue, Miami, FL, 33136, USA
- The Orthopedic Hospital, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266101, Shandong, China
| | - Gina D'Amato
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Papanicolaou Cancer Research Building, 1550 NW. 10Th Avenue, Miami, FL, 33136, USA
| | - Francis J Hornicek
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Papanicolaou Cancer Research Building, 1550 NW. 10Th Avenue, Miami, FL, 33136, USA
| | - Hao Tao
- The Orthopedic Hospital, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266101, Shandong, China.
| | - Zhenfeng Duan
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Papanicolaou Cancer Research Building, 1550 NW. 10Th Avenue, Miami, FL, 33136, USA.
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Zhang D, Wang L, Zhang L, Yao S, Wu J, Han S. Case report: A huge retroperitoneal solitary fibrous tumor closely related to the external iliac vessels misdiagnosed as an ovarian tumor. Front Med (Lausanne) 2024; 11:1383961. [PMID: 39026553 PMCID: PMC11254612 DOI: 10.3389/fmed.2024.1383961] [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: 02/08/2024] [Accepted: 06/20/2024] [Indexed: 07/20/2024] Open
Abstract
Background Solitary fibrous tumor (SFT) is a rare soft tissue tumor originating from mesenchymal cells. Thus far, there have been no reported cases of SFT closely related to the iliac vessels. Case presentation An elderly woman was found to have had a lower abdominal mass for more than 20 years. The enhanced computerized tomography (CT) showed a progressively enhanced hypervascular mass. The external iliac blood vessels were closely related to the mass, which was misdiagnosed as an ovarian tumor. During laparotomy, the external iliac vein was seen to penetrate the tumor, and the external iliac artery was seen to penetrate the tumor capsule. The retroperitoneal tumor was diagnosed during the operation. The surgical plan of complete tumor resection, severing of the external iliac arteries and veins, and blood vessel replacement was implemented. Pathological immunohistochemistry showed positive results for STAT6 and CD34, confirming the diagnosis of giant retroperitoneal SFT. The risk is classified as high and requires long-term follow-up. There has been no local recurrence or distant metastasis almost 1 year after surgery. Conclusion The incidence of giant retroperitoneal SFT is rare, and the diagnosis can be confirmed through preoperative imaging examination and pathological examination. If the SFT capsule is intact, there is a chance of surgical resection. For SFTs that are penetrated by the iliac blood vessels, adequate preparation must be made before the surgery is performed. Removing the tumor and the iliac blood vessels at the corresponding site and then replacing it with artificial blood vessels is a feasible method with less risk of bleeding. In this case, imaging showed a progressively enhancing hypervascular mass in the lower abdomen, which was related to blood vessels. Preoperative biopsy and pathological testing can confirm the diagnosis. Neoadjuvant therapy or interventional therapy before surgery can shrink the tumor, making the surgical procedure relatively easy with less risk of bleeding.
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Affiliation(s)
- Danni Zhang
- Department of Obstetrics and Gynecology, The 964th Hospital, Changchun, Jilin, China
| | - Li Wang
- Department of Obstetrics and Gynecology, The 964th Hospital, Changchun, Jilin, China
| | - Lili Zhang
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Shuzhi Yao
- Department of Surgery, The 964th Hospital, Changchun, Jilin, China
| | - Juntong Wu
- Department of Obstetrics and Gynecology, The 964th Hospital, Changchun, Jilin, China
| | - Song Han
- Pathology Department, The 964th Hospital, Changchun, Jilin, China
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Singer L, Singer J, Horbinski C, Penas-Prado M, Lukas RV. Immunotherapy for Solitary Fibrous Tumor (Hemangiopericytoma): A Unique Treatment Approach for a Rare Central Nervous System Tumor. Neurologist 2024; 29:250-253. [PMID: 38797934 DOI: 10.1097/nrl.0000000000000572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Solitary fibrous tumors (SFTs) of the central nervous system represent a unique entity with limited data on best treatment practices. CASE REPORT Here, we present a case of multiply recurrent central nervous system SFT treated with radiation and immunotherapy. Immunotherapy was chosen based on mutations of genes encoding DNA repair enzymes detected through next-generation sequencing of the tumor, DNA polymerase epsilon catalytic subunit ( POLE ) and mutL homolog 1. The use of radiation and immunotherapy led to slight shrinkage and no recurrence of the tumor for over 2 years. CONCLUSION The presence of somatic DNA repair enzyme gene mutations in SFT may suggest a benefit from a combination of radiotherapy and immunotherapy. This may serve as a biomarker for guiding management in patients with this rare tumor.
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Affiliation(s)
- Lauren Singer
- Malnati Brain Tumor Institute at the Robert H. Lurie Comprehensive Cancer Center
- Department of Neurology at Northwestern University, Chicago, IL
| | - Jorie Singer
- Tulane University School of Medicine, New Orleans, LA
| | - Craig Horbinski
- Malnati Brain Tumor Institute at the Robert H. Lurie Comprehensive Cancer Center
- Department of Neurological Surgery at Northwestern University, Chicago, IL
- Department of Pathology, at The Feinberg School of Medicine/Northwestern University, Chicago, IL
| | | | - Rimas V Lukas
- Malnati Brain Tumor Institute at the Robert H. Lurie Comprehensive Cancer Center
- Department of Neurology at Northwestern University, Chicago, IL
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Mohammed SR, Mack N, Ramoutar V, Rampersad J. Recurrent Hypoglycemia in a Non-diabetic Female: A Case Study on Doege-Potter Syndrome. Cureus 2024; 16:e63329. [PMID: 39077286 PMCID: PMC11283929 DOI: 10.7759/cureus.63329] [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] [Accepted: 06/27/2024] [Indexed: 07/31/2024] Open
Abstract
Solitary fibrous tumors (SFT) are mesenchymal cell tumors that may arise from any site throughout the body. A small percentage of patients with SFT develop non-islet cell tumor-induced hypoglycemia (NICTH), eponymously termed Doege-Potter Syndrome (DPS). DPS is characterized by severe, refractory hypoinsulinemic hypoglycemia. Diagnosis of SFT is dependent on histologic findings and immunohistochemistry (IHC). NAB2-STAT6 gene fusions are pathognomonic for SFT but may be difficult to identify in routine cytogenetic studies. STAT6 IHC is a highly sensitive and specific surrogate for the NAB2-STAT6 gene fusion. Total resection of the tumor remains the gold-standard definitive treatment of SFT of the pleura. Palliative tumor debulking is recommended if total resection is not feasible. We here report a case of DPS in a 73-year-old female, managed with palliative care.
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Affiliation(s)
- Saeed R Mohammed
- Department of Clinical Medical Sciences, The University of the West Indies, St. Augustine Campus, Champs Fleurs, TTO
| | - Narine Mack
- Department of Medicine, San Fernando General Hospital, San Fernando, TTO
| | - Valmikie Ramoutar
- Department of Medicine, San Fernando General Hospital, San Fernando, TTO
| | - Jessica Rampersad
- Department of Medicine, San Fernando General Hospital, San Fernando, TTO
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Leivaditis V, Ehle B, Papatriantafyllou A, Mulita F, Koletsis E, Verras GI, Tasios K, Antzoulas A, Charokopos N, Dahm M, Katsakiori PF, Grapatsas K. Addressing recurrent hypoglycaemia through thoracic surgical intervention: understanding Doege-Potter syndrome, a rarity in syndromes. Arch Med Sci Atheroscler Dis 2024; 9:e33-e40. [PMID: 38846055 PMCID: PMC11155461 DOI: 10.5114/amsad/183433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 01/29/2024] [Indexed: 06/09/2024] Open
Abstract
Doege-Potter syndrome (DPS), a rare paraneoplastic phenomenon characterised by non-islet cell tumour hypoglycaemia (NICTH), presents clinicians with intricate diagnostic and therapeutic challenges. This comprehensive review consolidates current understanding, clinical presentations, diagnostic modalities, therapeutic interventions, and emerging trends in managing DPS. The pathophysiology of DPS revolves around dysregulated insulin-like growth factors (IGF), particularly IGF-2, produced by mesenchymal tumours, notably solitary fibrous tumours (SFT). Clinical manifestations encompass recurrent hypoglycaemic episodes, often distinct from typical hypoglycaemia, with implications for insulin and counterregulatory hormone levels. Diagnosis necessitates a multidisciplinary approach integrating biochemical assays, imaging studies, and histopathological confirmation of the underlying neoplasm. Surgical resection remains the cornerstone of treatment, complemented by adjunctive therapies to manage persistent hypoglycaemia. Prognosis is influenced by successful tumour resection and long-term surveillance for recurrence. A patient-centred approach, incorporating supportive services and multidisciplinary care, is essential for optimal outcomes in individuals affected by DPS.
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Affiliation(s)
- Vasileios Leivaditis
- Department of Cardiothoracic and Vascular Surgery, WestpfalzKlinikum, Kaiserslautern, Germany
| | - Benjamin Ehle
- Department of Thoracic Surgery, Asklepios Lung Clinic Munich-Gauting, Gauting, Germany
| | | | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Efstratios Koletsis
- Department of Cardiothoracic Surgery, Patras University Hospital, Patras, Greece
| | | | - Konstantinos Tasios
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Andreas Antzoulas
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Nikolaos Charokopos
- Department of Cardiothoracic Surgery, Patras University Hospital, Patras, Greece
| | - Manfred Dahm
- Department of Cardiothoracic and Vascular Surgery, WestpfalzKlinikum, Kaiserslautern, Germany
| | | | - Konstantinos Grapatsas
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Centre, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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Yu Y, Gu F, Luo YL, Li SG, Jia XF, Gu LX, Zhang GP, Liao X. The role of tumor parenchyma and brain cortex signal intensity ratio in differentiating solitary fibrous tumors and meningiomas. Discov Oncol 2024; 15:32. [PMID: 38329652 PMCID: PMC10853156 DOI: 10.1007/s12672-024-00883-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/01/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFT) and meningiomas (MA) have similar clinical and radiographic presentations but require different treatment approaches and have different prognoses. This emphasizes the importance of a correct preoperative diagnosis of SFT versus MA. OBJECTIVE In this study, investigated the differences in imaging characteristics between SFT and MA to improve the accuracy of preoperative imaging diagnosis of SFT. METHODS The clinical and imaging data of 26 patients with SFT and 104 patients with MA who were pathologically diagnosed between August 2017 and December 2022, were retrospectively analyzed. The clinical and imaging differences between SFT and MA, as well as between the various pathological grades of SFT, were analyzed. RESULTS Age, gender, cystic change, flow void phenomenon, yin-yang sign, lobulation, narrow base, tumor/cortex signal ratio (TCSR) > 1.0 in T1-weighted imaging (T1WI), TCSR ≥ 1.1 in T2-weighted imaging (T2WI), peritumoral edema, and absence of dural tail sign varied between SFT and MA. As per the receiver operating characteristic (ROC) curve analysis, TCSR > 1 in T1WI has the maximum diagnostic accuracy for SFT. Cranial or venous sinus invasion had a positive effect on SFT (Grade III, World Health Organization (WHO) grading). CONCLUSION Among the many radiological and clinical distinctions between SFT and MA, TCSR ≥ 1 exhibits the highest predictive efficacy for SFT; while cranial or venous sinus invasion may be a predictor of WHO grade III SFT.
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Affiliation(s)
- Yue Yu
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, 28 Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou, China
| | - Fang Gu
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Yi-Lin Luo
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Shi-Guang Li
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Xiao-Feng Jia
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Liang-Xian Gu
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Guo-Ping Zhang
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China.
| | - Xin Liao
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, 28 Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou, China.
- Department of Radiology, Dushan County People's Hospital, No. 1 Ying Shang Road, Baiquan Town, Dushan County, 558299, Guizhou, China.
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7
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Medina-Ceballos E, Machado I, Giner F, Bujeda ÁB, Navarro S, Ferrandez A, Lavernia J, Ruíz-Sauri A, Llombart-Bosch A. Solitary fibrous tumor: Can the new Huang risk stratification system for orbital tumors improve prognostic accuracy in other tumor locations? Pathol Res Pract 2024; 254:155143. [PMID: 38301364 DOI: 10.1016/j.prp.2024.155143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 02/03/2024]
Abstract
Solitary fibrous tumors (SFTs) are known for their heterogeneous morphology, characterized by a variety of cell shapes and different growth patterns. They can also arise in various anatomical locations, most commonly in extremities and deep soft tissues. Despite this diversity in morphology and location, all SFTs share a common molecular signature involving the NAB2::STAT6 gene fusion. Due to their unpredictable clinical behavior, establishing prognostic factors is crucial. This study aims to evaluate an orbital risk stratification system (RSS) proposed by Huang et al. for use in extraorbital SFTs using a database of 97 cases. The Huang model takes into consideration tumor size, mitotic figures, Ki-67 index, and dominant constituent cell (DCC) as key variables. Survival analysis confirmed the model's predictive value, with higher-risk scores being associated with poorer outcomes. However, in contrast to the orbital SFTs studied by Huang et al., our study did not find a correlation between tumor size and recurrence in extraorbital cases. While the Huang model performs slightly better than other RSS, it falls short on achieving statistical significance in distinguishing recurrence risk groups in extraorbital locations. In conclusion, this study validates the Huang RSS for use in extraorbital SFTs and underscores the importance of considering DCC, mitotic count, and Ki-67 together. However, we found that including tumor size in this model did not improve prognostic significance in extraorbital SFTs. Despite the benefits of this additional RSS, vigilant monitoring remains essential, even in cases classified as low-risk due to the inherent unpredictability of SFT clinical outcomes.
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Affiliation(s)
- Emilio Medina-Ceballos
- Pathology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain; School of Medicine, Universidad de las Américas Puebla, 72810, Puebla, Mexico
| | - Isidro Machado
- Pathology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain; Patologika Laboratory, Quirón-Salud, Valencia, Spain; . Cancer CIBER (CIBERONC), Madrid, Spain.
| | - Francisco Giner
- Pathology Department, University Hospital "La Fe", 46010 Valencia, Spain
| | | | - Samuel Navarro
- Pathology Department, University of Valencia, 46010 Valencia, Spain; . Cancer CIBER (CIBERONC), Madrid, Spain
| | | | - Javier Lavernia
- Department of Oncology, Instituto Valenciano de Oncología, 46009 Valencia, Spain
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Janik AM, Terlecka A, Spałek MJ, Boye K, Szostakowski B, Chmiel P, Szumera-Ciećkiewicz A, Bobak K, Świtaj T, Rutkowski P, Czarnecka AM. Diagnostics and Treatment of Extrameningeal Solitary Fibrous Tumors. Cancers (Basel) 2023; 15:5854. [PMID: 38136399 PMCID: PMC10742263 DOI: 10.3390/cancers15245854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Solitary fibrous tumors (SFT) are rare mesenchymal neoplasms that account for less than 2% of all soft tissue masses. In the latest WHO 2020 Classification of Soft Tissue Tumors, extrameningeal SFT was listed as intermediate (rarely metastasizing) or malignant neoplasms. Due to the lack of characteristic clinical features, their diagnosis and treatment remain challenging. The pathogenesis of SFT is often associated with the presence of fusions of the NAB2-STAT6 gene on the 12q13 chromosome. Cytoplasmic CD34 positive staining is considerably characteristic for most SFTs; less frequently, factor XII, vimentin, bcl-2, and CD99 are present. A key factor in the diagnosis is the prevalent nuclear location of STAT6 expression. Radical resection is the mainstay of localized SFTs. In the case of unresectable disease, only radiotherapy or radio-chemotherapy may significantly ensure long-term local control of primary and metastatic lesions. To date, no practical guidelines have been published for the treatment of advanced or metastatic disease. Classical anthracycline-based chemotherapy is applicable. The latest studies suggest that antiangiogenic therapies should be considered after first-line treatment. Other drugs, such as imatinib, figitumumab, axitinib, and eribulin, are also being tested. Definitive radiotherapy appears to be a promising therapeutic modality. Since standards for the treatment of advanced and metastatic diseases are not available, further investigation of novel agents is necessary.
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Affiliation(s)
- Anna Maria Janik
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Terlecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Mateusz J. Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, 02-718 Warsaw, Poland
| | - Kjetil Boye
- Department of Oncology, Oslo University Hospital, 0372 Oslo, Norway;
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Paulina Chmiel
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Diagnostic Hematology Department, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Klaudia Bobak
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Tomasz Świtaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.J.); (A.T.); (M.J.S.); (B.S.); (P.C.); (K.B.); (T.Ś.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute Polish Academy of Sciences, 02-106 Warsaw, Poland
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Talaat A, Mcguirt A. Recurrent Solitary Fibrous Tumor in a 73-Year-Old Male Presenting With Small Bowel Obstruction: A Case Report. Cureus 2023; 15:e44297. [PMID: 37779748 PMCID: PMC10533948 DOI: 10.7759/cureus.44297] [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: 05/05/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Solitary fibrous tumors (SFTs) are rare soft tissue tumors that can arise in the abdomen, pleura, and central nervous system, among other sites. Surgical resection is the mainstay of management, although recurrence rates remain substantial. This case describes a 73-year-old male treated surgically for both a recurrent SFT and small bowel obstruction (SBO) secondary to adhesions. The patient had undergone numerous intra-abdominal operations for malignant SFT since 1994, highlighting the importance of meticulous resection at the initial presentation of local disease.
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Affiliation(s)
- Adam Talaat
- Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Aron Mcguirt
- General Surgery, Bay Pines Veterans Affairs (VA) Health Care System, St. Petersburg, USA
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10
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Riaz S, Priftakis D, Afaq A, Kayani I, Bomanji J. 68 Ga-PSMA-Avid Intranasal Solitary Fibrous Tumor. Clin Nucl Med 2023; 48:e184-e185. [PMID: 36727873 DOI: 10.1097/rlu.0000000000004572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT The utility of molecular imaging in solitary fibrous tumors has not been fully established. We present a rare case of recurrent intranasal solitary fibrous tumor incidentally localized on 68 Ga-PSMA PET/CT scan, which turned out to be metabolically inactive on 18 F-FDG PET/CT.
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Affiliation(s)
- Saima Riaz
- From the Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom
| | - Dimitrios Priftakis
- From the Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom
| | - Asim Afaq
- Department of Radiology, University of Iowa Roy Carver College of Medicine, Iowa City, IA
| | - Irfan Kayani
- From the Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom
| | - Jamshed Bomanji
- From the Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom
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11
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Cox J, Leesley H, DeAnda A, Uran DP, Lick S. Resection of a giant thoracic solitary fibrous tumor treated with preoperative arterial coiling followed by a double-level thoracotomy. J Surg Case Rep 2023; 2023:rjad008. [PMID: 36685116 PMCID: PMC9851658 DOI: 10.1093/jscr/rjad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023] Open
Abstract
Solitary fibrous tumor (SFT) are rare pleura neoplasms often localized to middle or inferior hemithorax. A middle-aged woman presents to the emergency department following a motor vehicle accident, the computed tomography scan revealed a giant tumor occupying the entire left pleural cavity with a complete collapse of the left lung and substantial right deviation of heart and mediastinum. Using preoperative arterial coiling followed by a double-level thoracotomy we successfully resected the giant tumor. The SFT weighed ~10 lbs. At 2-month follow-up visit patient reports mild discomfort during strenuous movement/heavy lifting but denies any shortness of breath.
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Affiliation(s)
- Jessica Cox
- School of Medicine, University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Haley Leesley
- Department of Cardiovascular and Thoracic Surgery, University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Abe DeAnda
- Department of Cardiovascular and Thoracic Surgery, University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Diana Palacio Uran
- Department of Radiology, University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Scott Lick
- Correspondence address. Department of Cardiovascular and Thoracic surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA. Tel: 409-772-1203; Fax: 409-772-1421; E-mail:
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12
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Dudde F, Giese M, Henkel KO. Metastasis of a Solitary Fibrous Tumor in the Mandible: A Case Report. CANCER DIAGNOSIS & PROGNOSIS 2023; 3:107-114. [PMID: 36632580 PMCID: PMC9801440 DOI: 10.21873/cdp.10187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND/AIM The solitary fibrous tumor (SFT) is a mesenchymal neoplasm and belongs to the group of soft tissue sarcomas. The SFT is characterized by indolent, slowly progressive growth and manifests itself clinically by compression of neighboring structures. The treatment of choice is surgical removal of the tumor. In advanced stages, there is also the possibility of chemotherapy, systemic therapy, or immunotherapy, as well as radiotherapy. Depending on their location and severity, SFTs show different recurrence rates and survival functions. CASE REPORT The present case report shows an extremely rare localization of a low-risk SFT in the floor of the mouth. Despite complete surgical removal of the SFT, the patient showed a metastasis of the SFT in the mandible two years postoperatively. Therefore, this case report shows that even a low-risk SFT in the localized stage can metastasize despite of total surgical removal. Consequently, SFTs of the head and neck region require close clinical and imaging follow-up. CONCLUSION Although the localization of the SFT in the oral cavity is a rarity, this entity should be included in the differential diagnosis in the case of long-term space-occupying processes in the head and neck region. This report is the first regarding metastasis of a SFT to the mandible.
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Affiliation(s)
- Florian Dudde
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | - Manfred Giese
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | - Kai-Olaf Henkel
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
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Evaluation of Alternative Risk Stratification Systems in a Large Series of Solitary Fibrous Tumors with Molecular Findings and Ki-67 Index Data: Do They Improve Risk Assessment? Int J Mol Sci 2022; 24:ijms24010439. [PMID: 36613891 PMCID: PMC9820154 DOI: 10.3390/ijms24010439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
The clinical evolution of solitary fibrous tumors (SFTs) is often uncertain and several risk stratification systems (RSS) have been proposed. The Demicco et al. RSS is the most frequently implemented. In this study we aim to validate two alternative RSS (Sugita et al. and G-Score) using results for the Demicco RSS from a previous study of 97 SFTs. In addition, we aim to determine whether reclassified cases had any distinctive molecular features. As the Sugita et al. system substitutes mitotic count with Ki-67 index we also investigated whether Ki-67 results for tissue microarrays are comparable to those obtained using whole tissue sections. In the present study we detected that many cases classified by Demicco RSS as low-risk were reclassified as intermediate risk using the new system (G-score RSS). Kaplan-Meier survival plots for G-Score RSS showed that the low-risk and intermediate-risk SFTs had a similar evolution that contrasted with the more aggressive high-risk group. Moreover, the similar evolution in both low and intermediate-risk groups occurred despite the G-score system being stricter in classifying low-risk tumors. We observed that Sugita RSS does not provide any better risk stratification in comparison with the Demicco RSS, and testing both RSS in our series produced similar Kaplan-Meier survival data. We found some discordant results when comparing whole sections and the corresponding tissue microarrays samples, finding the hotspot areas easier to locate in whole sections. Forty-one SFTs with initial low-risk assigned by the Demicco RSS were reclassified as intermediate-risk by G-score finding both TP53 and HTER mutations in four cases, only HTER mutation in 11 cases, and only TP53 mutation in 2 cases. All six cases of SFT classified as high-risk by both the Demicco and G-score RSS suffered recurrence/metastasis, and half showed both TP53 and HTER mutations. Five SFTs were categorized as low-risk by both Demicco and G-score, of which 4 cases revealed HTER mutation. Regarding the outcome of these 5 patients, two were lost to follow-up, and one of the remaining three patients suffered recurrence. We believe that although the presence of both TP53 and HTER mutations may confer or be related to poor evolution, the isolated presence of HTER mutation alone would not necessarily be related to poor outcome. The G-score RSS more accurately identified low-risk patients than the other two risk models evaluated in the present series. Late recurrence/metastasis may occasionally be observed even in low-risk SFTs categorized by stricter classification systems such as the G-score RSS. These findings support the possibility that additional, as yet unknown factors may influence the clinical evolution of SFTs. In conclusion, given the possibility of late recurrence, long-term follow-up is recommended for all SFT patients, even in cases classified as low risk by the stricter G-score system. An integration of clinical, radiological, pathological, and molecular findings may improve SFT risk stratification and better predict patient outcome.
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14
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Pourfarrokh N, Wang Y, Cleaves C, Zreik R, Leng B. Solitary Fibrous Tumor of Hard Palate: A Case Report and Literature Review. J Investig Med High Impact Case Rep 2022; 10:23247096221142275. [PMID: 36546664 PMCID: PMC9793056 DOI: 10.1177/23247096221142275] [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: 12/24/2022] Open
Abstract
Solitary fibrous tumor (SFT) is a mesenchymal tumor accounting for less than 2% of soft tissue tumors and has variable clinical behavior. It can arise in many anatomical locations of the body and in rare occasions in the oral cavity mostly in buccal mucosa and tongue. To date, a handful of such cases have been reported in the hard palate. We present a case of SFT in the hard palate of a 32-year-old man and describe the tissue morphology, immunohistochemistry workup, and follow-up together with literature review.
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Affiliation(s)
| | - Yilun Wang
- Texas A&M University Health Science
Center, College Station, USA
| | | | - Riyam Zreik
- Baylor Scott & White Medical
Center–Temple, TX, USA
| | - Bing Leng
- Baylor Scott & White Medical
Center–Temple, TX, USA,Bing Leng, MD, PhD, Department of
Pathology, Baylor Scott & White Medical Center–Temple, 2401 S. 31st Street,
Temple, TX 76508, USA.
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15
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Andrade MDO, de Sousa NDC, do Amaral PS, da Costa SCS, de Lima LGCA, Lourenço DM, Feher O. Doege-Potter syndrome associated to metastatic solitary fibrous tumor. Autops Case Rep 2022; 12:e2021412. [PMID: 36569984 PMCID: PMC9762516 DOI: 10.4322/acr.2021.412] [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: 10/23/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022]
Abstract
Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal neoplasm with an estimated annual incidence of 0.35 per 100,000 individuals. Doege-Potter syndrome is a paraneoplastic syndrome related to solitary fibrous tumor clinically characterized by hypoglycemia, occurring in less than 5% of cases. Herein, we report a case of metastatic SFT associated with recurrent severe hypoglycemia. A 43-year-old male with a noncontributory medical history presented with a painless and progressive growing mass in the right thigh. The histological evaluation rendered the diagnosis of SFT, and tumor resection was performed. One year after the operation, on the oncological follow-up, he was admitted to the emergency unit, manifesting an early-morning seizure associated with a severe hypoglycemia. The laboratory findings of non-islet cell tumor hypoglycemia (NICTH) in the background of a relapsed metastatic solitary fibrous tumor were consistent with the diagnosis of Doege-Potter syndrome. Hepatic embolization associated with oral glucocorticoid was an efficient palliative treatment to control the hypoglycemic crisis and allow hospital discharge.
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Affiliation(s)
- Matheus de Oliveira Andrade
- Universidade de São Paulo (USP), Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Departamento de Oncologia Clínica, São Paulo, SP, Brasil
| | - Nathália da Cruz de Sousa
- Universidade de São Paulo (USP), Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Departamento de Endocrinologia, São Paulo, SP, Brasil
| | - Paulo Siqueira do Amaral
- Universidade de São Paulo (USP), Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Departamento de Oncologia Clínica, São Paulo, SP, Brasil
| | - Samantha Cabral Severino da Costa
- Universidade de São Paulo (USP), Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Departamento de Oncologia Clínica, São Paulo, SP, Brasil
| | | | - Delmar Muniz Lourenço
- Universidade de São Paulo (USP), Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Departamento de Endocrinologia, São Paulo, SP, Brasil
| | - Olavo Feher
- Universidade de São Paulo (USP), Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Departamento de Oncologia Clínica, São Paulo, SP, Brasil
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Peng Y, Jiang Y, Ding S, Zheng Y, Tang W, Liu J. Solitary fibrous tumors in prostate: a case report with review of the literature. Aging Male 2022; 25:219-227. [PMID: 35989611 DOI: 10.1080/13685538.2022.2110232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Solitary fibrous tumor (SFT) is a relatively rare type of mesenchymal neoplasm that occurs most frequently in the pleura. However, SFT originating from the prostate is particularly uncommon and only approximately 39 cases were reported before. Herein, we reported a rare case of a patient diagnosed with prostate SFT and presented a literature review.Case presentation: A 50-year-old Asian with irritative urinary symptoms was admitted to our hospital and almost all the evidence indicated that benign prostate hyperplasia (BPH) caused his symptoms. Therefore, transurethral resection of the prostate (TURP) was performed, but histopathological and Immunohistochemical (IHC) assessments showed that spindle cells arranged disorderly in the TURP specimen with a cluster of differentiation 34 (CD34), B-cell lymphoma-2 (Bcl-2), and signal transducer and activator of transcription 6 (STAT6) highly expressed and SFT was diagnosed. Finally, the patient underwent a radical prostatectomy and there was no disease progression observed thereafter. CONCLUSIONS Prostate SFT is extremely rare, and to our knowledge, this is the first case of prostate SFT that is difficult to differentiate from small volume BPH. IHC examinations are of great diagnostic value. Radical resection of the tumor appears to be the most effective method at present and continuous follow-up is highly recommended.
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Affiliation(s)
- Yueqiang Peng
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Jiang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Siwei Ding
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yongbo Zheng
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Tang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiayu Liu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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