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Dörr NM, Krüger M, Möller M, Zinne N, Toennies M, Schega O, Ritter C, Decker S, Hölsken A, Schütte W, Biancosino C. Solitary fibrous tumours of the pleura: do we need a different perspective on malignancy? Eur J Cardiothorac Surg 2024; 65:ezae096. [PMID: 38479834 DOI: 10.1093/ejcts/ezae096] [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: 09/11/2023] [Revised: 03/01/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES Solitary fibrous tumours of the pleura (SFTP) are historically considered to be benign soft tissue neoplasms. However, a clinical relevant number of these neoplasms have malignant histological features. The objective of this study was to evaluate the percentage of SFTP presenting unfavourable clinical behaviour in order to predict negative long-term outcome. METHODS A retrospective review of 74 patients treated at 4 hospitals between 1990 and 2013 was performed. The median follow-up was 10 years (range: 1-20 years). Risk of tumour recurrence and metastases (unfavourable clinical behaviour) with regard to histology using the Kaplan-Meier and Cox proportional hazards methods. RESULTS The mean age was 61 years (SD 12.75 years). There were 31 male patients (58%) and 43 female patients (42%). Tumour size ranged from 1 to 30 cm (mean 9.09 cm; SD 6.22 cm). Complete resection (R0) was achieved by minimally invasive thoracoscopic resection in 29% and thoracotomy in 57%; 25% of SFTPs showed histological evidence of malignancy, according to England criteria. Recurrence occurred in 21% and 10% of patients had metastases; 83% of patients with metastases and 39% of patients with recurrence died within 5 years. The median recurrence-free survival for histologically benign SFTP was not reached, compared to 8 years for malignant SFTP. The five-year overall survival rate was 84%. Mitotic rate ≥1/10 HPF, high cellularity, nuclear atypia, Ki-67 level >5% and poorly circumscribed (sessile) growth pattern were associated with poor long-term outcome. CONCLUSIONS Pathological differentiation of SFTP morphology into pedunculated, well circumscribed and poorly circumscribed (sessile) growth pattern is recommended. Due to the misleading classification into histologically benign and malignant, all unpedunculated SFTP should be classified as potentially aggressive. Lifelong follow-up is mandatory.
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Affiliation(s)
- Niels Michael Dörr
- Department of Thoracic Surgery, Martha-Maria Hospital Halle-Dölau, Halle, Germany
- Medical Faculty of the Martin Luther University Halle-Wittenberg, University Hospital Halle, Halle, Germany
| | - Marcus Krüger
- Department of Thoracic Surgery, Martha-Maria Hospital Halle-Dölau, Halle, Germany
- Medical Faculty of the Martin Luther University Halle-Wittenberg, University Hospital Halle, Halle, Germany
| | - Miriam Möller
- Department of Pneumology, Martha-Maria Hospital Halle-Dölau, Halle, Germany
| | - Norman Zinne
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Mario Toennies
- Department of Thoracic Surgery, HELIOS Hospital Emil von Behring, Berlin, Germany
| | - Olaf Schega
- Department of Thoracic Surgery, Johanniter Hospital Treuenbrietzen, Germany
| | | | - Steffen Decker
- Department of Thoracic Surgery, Heinrich-Braun Hospital Zwickau, Germany
| | - Antje Hölsken
- Department of Pathology, Martha-Maria Hospital Halle-Dölau, Halle, Germany
| | - Wolfgang Schütte
- Department of Pneumology, Martha-Maria Hospital Halle-Dölau, Halle, Germany
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Meier C, Eckstein A, Baba HA, Sichward LH, Grabellus F, Li Y, Ziegenfuß CD, Mohr C, Pförtner R. Solitary Fibrous Tumours of the Orbit - Clinical Pathology, Therapy and Prognosis. Klin Monbl Augenheilkd 2024; 241:15-29. [PMID: 37967817 DOI: 10.1055/a-2165-6550] [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: 11/17/2023]
Abstract
BACKGROUND Solitary fibrous tumours are rare. The aim of this study is to describe the clinical features, therapy and outcome of affected patients and to identify factors associated with recurrence. METHODS Retrospective study of a cohort of 20 patients who underwent surgery for orbital solitary fibrous tumour at the University Department of Oral and Maxillofacial Surgery between 2002 and 2023. Demographic, clinical, and therapeutic data as well as tumour follow-up results were collected. Tumour volume and molecular genetic mutations were retrospectively determined. RESULTS The median patient age was 49.5 years at initial surgery. The left orbit was affected in 65% of cases. The most common clinical symptom was proptosis (80%). This was reported with a mean lateral difference of 3.9 mm (range: 1 - 10 mm). The tumours were localised predominantly in the intra- and extraconal space, craniolateral quadrant and middle third. The median tumour volume was 7.66 cm³ (range 2.15 - 12.57 cm³). In all patients, the diagnosis was made by pathological examination. All tumours investigated showed a NAB2-STAT6 mutation. The most frequently detected mutation was the fusion NAB2 exon 4 - STAT6 exon 2. All patients were initially managed with frontolateral orbitotomy. Incomplete resection (R1-status) occurred in 35% (n = 7). The recurrence rate was 25% (n = 5), with a median disease-free interval of 45.5 months (range 23 - 130). 80% (n = 4) of recurrences were initially R1-resected. CONCLUSION Orbital solitary fibrous tumours are rare tumours and are clinically manifested by signs of displacement of orbital structures. Diagnosis is made by histology and immunohistochemistry and can be proven with the molecular genetic detection of the NAB2-STAT6 mutation. The therapy of choice is complete surgical resection. R1-resection is more likely in the intraconal location as well as in location in the posterior third of the orbit - due to difficult surgical accessibility. The greatest risk factor for the development of recurrence is incomplete surgical excision. Late recurrences are possible, which is why a long-term connection to a specialised clinic is necessary.
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Affiliation(s)
- Chiara Meier
- Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinik für Mund-, Kiefer- & Gesichtschirurgie, Klinken Essen-Mitte, Essen, Deutschland
| | - Anja Eckstein
- Orthoptik, Universitäts-Augenklinik Essen, Deutschland
| | | | | | | | - Yan Li
- Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Deutschland
| | - Christoph David Ziegenfuß
- Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Deutschland
| | - Christopher Mohr
- Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinik für Mund-, Kiefer- & Gesichtschirurgie, Klinken Essen-Mitte, Essen, Deutschland
| | - Roman Pförtner
- Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinik für Mund-, Kiefer- & Gesichtschirurgie, Klinken Essen-Mitte, Essen, Deutschland
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3
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Shaker N, Wu D, Abid AM. Cytology of malignant pleural mesothelioma: Diagnostic criteria, WHO classification updates, and immunohistochemical staining markers diagnostic value. Diagn Cytopathol 2022; 50:532-537. [PMID: 36069384 PMCID: PMC9826471 DOI: 10.1002/dc.25053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 01/11/2023]
Abstract
Malignant pleural mesothelioma (MPM) is a rare but aggressive malignancy with a poor prognosis. Because of this tumor rarity and overlapping histologic features with other malignancy types, the histopathological findings and diagnostic immunohistochemical workup are essential in establishing the final diagnosis of MPMs. We aimed to review the diagnostic criteria, WHO tumor classification updates, and immunohistochemical staining markers diagnostic value to achieve an appropriate clinical diagnosis.
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Affiliation(s)
- Nada Shaker
- Department of PathologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Douglas Wu
- Department of PathologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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Ozaniak A, Hladik P, Lischke R, Strizova Z. Diagnostic challenges and treatment options in patients with solitary fibrous tumor: A single-center observational study. Front Surg 2022; 9:952463. [PMID: 36277294 PMCID: PMC9583656 DOI: 10.3389/fsurg.2022.952463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/27/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Solitary fibrous tumor (SFT) is an extremely rare disease with a high misdiagnosis rate and a potentially malignant biologic nature. We have collected and analyzed data from 18 SFT patients to provide a deeper insight into this uncommon disease entity. Methods In our study, 18 patients who had undergone surgery between April 2014 and December 2021 for the diagnosis of SFT were evaluated. The collected data for each patient included the location of the SFT, the preoperative diagnosis, the definitive histological diagnosis, the presence of postoperative complications, the time of recurrence, the time of systemic progression, the type of treatment, and the survival rate. The median follow-up was 36 months. Results In three patients, the preoperative diagnosis did not correlate with the definitive histology of SFT. In patients with the limb location of SFT, no signs of recurrence nor distant metastases were seen within the study period. In total, 50% of the postsurgical complications were associated with the abdominal location of the SFT. In newly diagnosed SFT patients, two patients (20%) developed local recurrence, and the median time until recurrence was 22.5 months. Out of patients that were admitted and operated on for recurrent SFT, 67% relapsed, and the median time to relapse was 9.5 months. The systemic progression of the disease was observed in 33% of patients treated for recurrent SFT. Conclusion In our study, the misdiagnosis rate was high and correlated with previously published studies. Postsurgical complications were associated with the extrathoracic location of SFT. The mainstay of SFT treatment remains radical surgery, although radiotherapy alone can significantly improve overall survival. Clinical trials are urgently needed to evaluate the potential effect of other treatment modalities, such as immunotherapy and targeted therapy, in SFT patients.
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Affiliation(s)
- Andrej Ozaniak
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Pavel Hladik
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Robert Lischke
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Zuzana Strizova
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic,Correspondence: Zuzana Strizova
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Lensing RJ, Broos WAM, van der Zant FM, Knol RJJ. Focal PSMA-Positive Pleural Lesion in a Patient With Stage II Prostate Carcinoma. Clin Nucl Med 2022; 47:e170-e171. [PMID: 35006116 DOI: 10.1097/rlu.0000000000003985] [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: 11/25/2022]
Abstract
ABSTRACT A 70-year-old man with histopathologically proven prostate carcinoma (Gleason, 5 + 5; prostate-specific antigen level, 6.2 μg/mL) was referred for an 18F-PSMA-1007 PET/CT scan. The scan revealed bilateral PSMA uptake in the prostate, representing the primary tumor, but no evidence of PSMA-positive lymph nodes. However, a left-sided ventral pleural thickening showed focal PSMA uptake. Lesion biopsy showed no signs of malignancy, and prostatectomy was performed. The 1-year follow-up CT thorax showed growth of approximately 20% of the pleural lesion. Subsequently, video-assisted thoracic surgery of the lesion was performed. Histopathology showed a solitary fibrous tumor, a rare mesenchymal tumor.
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Badawy M, Nada A, Crim J, Kabeel K, Layfield L, Shaaban A, Elsayes KM, Gaballah AH. Solitary fibrous tumors: Clinical and imaging features from head to toe. Eur J Radiol 2021; 146:110053. [PMID: 34856518 DOI: 10.1016/j.ejrad.2021.110053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/03/2021] [Accepted: 11/15/2021] [Indexed: 12/12/2022]
Abstract
Solitary fibrous tumors (SFTs) are rare fibroblastic mesenchymal tumors that are usually benign with variable malignant potential. They can develop in any organ due to their spindle cell origin. The exact etiology of solitary fibrous tumors is unknown. The majority of SFTs are benign with 10-30% of them exhibiting aggressive and malignant features. The aggressiveness of this type of tumor is not associated with its histological features, which makes surgical resection the treatment of choice. We will review the clinical and radiological features and possible differential diagnoses of SFTs according to their anatomical sites following the World Health Organization 2020 classification.
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Affiliation(s)
- Mohamed Badawy
- Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| | - Ayman Nada
- Department of Radiology, University of Missouri Health Care, Columbia, MO, United States.
| | - Julia Crim
- Department of Radiology, University of Missouri Health Care, Columbia, MO, United States.
| | - Khalid Kabeel
- Department of Radiology, University of Missouri Health Care, Columbia, MO, United States.
| | - Lester Layfield
- Department of Pathology, University of Missouri Health Care, Columbia, MO, United States.
| | - Akram Shaaban
- Department of Diagnostic Imaging, University of Utah, Salt Lake City, UT, United States.
| | - Khaled M Elsayes
- Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| | - Ayman H Gaballah
- Department of Radiology, University of Missouri Health Care, Columbia, MO, United States.
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7
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Kiely NP, Sinha R, Tang K, Wan KM. Doege-Potter syndrome: a systematic review of the literature and case presentation of a rare pelvic malignant solitary fibrous tumour. BMJ Case Rep 2021; 14:e242447. [PMID: 34413033 PMCID: PMC8378376 DOI: 10.1136/bcr-2021-242447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/04/2022] Open
Abstract
Solitary fibrous tumours (SFTs) are a rare mesenchymal neoplasm with an incidence of 2.8 per 100 000 of which only 1% occur in the female genital tract. Doege-Potter syndrome is a paraneoplastic phenomenon associated with approximately 5%-10% of SFTs and is characterised by non-islet cell hypoglycaemia due to tumour production of low molecular weight insulin-like growth factor-II. We present the fourth confirmed case of female pelvic SFT with Doege-Potter syndrome and a literature review.
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Affiliation(s)
- Neill Paul Kiely
- School of Women and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Obstetrics and Gynaecology, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Rinkita Sinha
- School of Women and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Katrina Tang
- Department of Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - King Man Wan
- School of Women and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Royal Hospital for Women, Randwick, New South Wales, Australia
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8
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Li ZK, Liu J, Chen C, Yang KY, Deng YT, Jiang Y. Locally advanced malignant solitary fibrous tumour successfully treated with conversion chemotherapy, operation and postoperative radiotherapy: a case report. J Int Med Res 2021; 49:300060521996940. [PMID: 33719644 PMCID: PMC7952856 DOI: 10.1177/0300060521996940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Preoperative diagnosis of solitary fibrous tumour (SFT) may not provide a complete tumour picture and may be inaccurate. There is no standard treatment for locally advanced or metastasised malignant SFT (MSFT). Here, the case of a 17-year-old male patient with final pathology diagnosis of MSFT is reported. Preoperative biopsy pathology results suggested an Ewing sarcoma that was positive for CD99 antigen, vimentin, friend leukaemia integration 1 transcription factor, apoptosis regulator Bcl-2, and synaptophysin; and negative for CD34 antigen, S-100 protein (S-100), smooth muscle antigen, cytokeratin, and Wilms tumour 1 associated protein. The Ki67 positive rate was 8%, so the patient initially received eight cycles of conversion chemotherapy (vincristine, etoposide, ifosfamide and pirarubicin for one cycle, and vincristine, doxorubicin, and cyclophosphamide/ifosfamide and etoposide for 7 cycles in total). The tumour shrunk significantly and was surgically removed. The final pathology diagnosis was MSFT that was positive for CD99 and signal transducer and activator of transcription 6, and negative for CD34, tumour protein 63, S-100, desmin, and epithelial membrane antigen. Fluorescence in situ hybridization showed no gene translocation in EWS RNA binding protein 1, SS18 subunit of BAF chromatin remodelling complex or FUS RNA binding protein. The patient finally accepted adjuvant radiotherapy of 5600 cGy. Disease-free survival has been > 1 year, with no recurrence or metastasis detected to date. MSFT is rare and treatment for locally advanced or metastatic MSFT remains controversial. The efficacy of the present therapeutic strategy requires further research.
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Affiliation(s)
- Zhi-Ke Li
- Department of Medical Oncology, Cancer Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Liu
- Department of Medical Oncology, Cancer Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Chen Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Ke-Yi Yang
- Department of Medical Oncology, Cancer Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yao-Tiao Deng
- Department of Medical Oncology, Cancer Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Jiang
- Department of Medical Oncology, Cancer Centre, West China Hospital, Sichuan University, Chengdu, China
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9
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Salimov ZM, Pikin OV, Ryabov AB, Popov MI, Kononets PV, Volchenko NN, Blinov DA, Nikulin KA. [Solitary fibrous tumor of pleura (symptoms, diagnosis, treatment)]. Khirurgiia (Mosk) 2020:35-41. [PMID: 32869613 DOI: 10.17116/hirurgia202008135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Optimization of diagnosis and treatment of patients with solitary fibrous tumor of pleura, analysis of overall survival and disease-free survival, predictors of recurrence. MATERIAL AND METHODS There were 66 patients with solitary fibrous tumor of pleura (26 men and 40 women) aged 57.6 years (range 26-80 years). Asymptomatic course was found in 29 (44%) patients, various symptoms - in 37 (56%) patients. Thoracotomy was applied in 36 patients, thoracoscopy - in 30 patients. Immunohistochemical examination included analysis of definition of Stat6 expression. RESULTS Benign variant of SFT was diagnosed in 50 (75.7%) patients, malignant variant - in 16 (24.3%) patients. STAT6 expression was observed in all cases. Postoperative morbidity was 9%, mortality - 1.6%. Recurrence was diagnosed in 2 (4%) patients with benign variant of disease and in 5 (31.2%) patients with malignant variant (2 of them died from progression of disease). Progression-free survival was 89.4%, overall survival - 95.4%. Predictors of recurrence are tumor dimension over 10 cm, necrosis and/or hemorrhagic component of tumor, mitotic count of at least four per 10 high-power fields. CONCLUSION. S Olitary fibrous tumor of pleura is a rare mesenchymal fibroblastic neoplasm growing from submesothelial layer. Differential and preoperative morphological diagnosis of SFT is difficult and demands a special immunohistochemical examination with analysis of Stat 6 expression. Surgery is preferred for tumor de novo and recurrent neoplasm.
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Affiliation(s)
- Z M Salimov
- Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - O V Pikin
- Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - A B Ryabov
- Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - M I Popov
- Moscow City Oncology Hospital No 62, Moscow, Russia
| | - P V Kononets
- Moscow City Oncology Hospital No 62, Moscow, Russia
| | - N N Volchenko
- Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - D A Blinov
- Moscow City Oncology Hospital No 62, Moscow, Russia
| | - K A Nikulin
- Moscow City Oncology Hospital No 62, Moscow, Russia
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10
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Kipourou M, Tsanaktsidis I, Zibilidis G. A Moving Pleural Mass. Arch Bronconeumol 2020; 57:225. [PMID: 32291101 DOI: 10.1016/j.arbres.2019.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/30/2019] [Accepted: 11/03/2019] [Indexed: 10/24/2022]
Affiliation(s)
- Maria Kipourou
- Pulmonology Department, 424 General Military Hospital, Thessaloniki, Greece.
| | - Ioannis Tsanaktsidis
- Computed Tomography Department, 424 General Military Hospital, Thessaloniki, Greece
| | - Georgios Zibilidis
- Interventional Radiology Department, 424 General Military Hospital, Thessaloniki, Greece
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11
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Kaya EA, Carlson JD, Thomas CJ, Wagner AE, Fairbanks RK, Lamoreaux WT, Lee CM. Single Solitary Fibrous Tumor Brain Metastasis in a Patient with Simultaneous Adenocarcinoma of the Lung: Case Report and Review of the Literature. Case Rep Med 2020; 2020:3938270. [PMID: 32318112 PMCID: PMC7166291 DOI: 10.1155/2020/3938270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/24/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022] Open
Abstract
We present a unique case of a patient simultaneously diagnosed with solitary fibrous tumor (SFT) and unrelated adenocarcinoma of the lung, both proven with separate pathology. It was subsequently found that the SFT had metastasized to the brain by additional pathology, and not the predicted adenocarcinoma. SFTs are a rare mesenchymal neoplasm that accounts for less than 2% of all reported soft tissue tumors. SFTs most commonly arise in the thoracic cavity, but are frequently found in various locations throughout the body, and rarely metastasize to the brain. This case highlights that rare neoplasms, such as SFT, should not be ruled out as a potential cause of metastasis. Due to the rarity of this clinical situation, we also provide a review and discussion of previously reported SFT cases and the use of postoperative radiation therapy. The optimal treatment for individual patients remains unclear in this unique situation. Surgical resection followed by adjuvant Gamma Knife radiation therapy to the surgical bed appears to be a safe option for local treatment of SFT in select patients. Further studies are needed of this rare clinical situation in order to better understand and optimize future treatments for patients with SFT and metastasis to the brain.
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Affiliation(s)
- Erin A Kaya
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
- Washington State University (WSU) Elson S. Floyd College of Medicine (ESFCOM), Spokane, WA, USA
| | | | | | - Aaron E Wagner
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Robert K Fairbanks
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Wayne T Lamoreaux
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Christopher M Lee
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
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12
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Liu D, Wang Y, Zheng Y, Zhang HL, Wang ZH. Massive malignant solitary fibrous tumor of the diaphragm: A case report. Medicine (Baltimore) 2020; 99:e18992. [PMID: 32000437 PMCID: PMC7004793 DOI: 10.1097/md.0000000000018992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/03/2019] [Accepted: 12/30/2019] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Malignant solitary fibrous tumor (MSFT) of the diaphragm is extremely rare, and to the best of our knowledge, only three cases have been reported in the past two decades. In all these cases, the diaphragms were usually reconstructed with artificial diaphragm patch because of the extensive resection. PATIENT CONCERNS We reported a male patient with complaints of dyspnea, chest pain and massive pleural effusion in the left chest detected by chest X-ray. A huge mass of 20 × 20 cm was seen in the left lower chest in the computed tomography (CT) scan. DIAGNOSIS The diagnosis of MSFT originating in the diaphragm was made by post-operative immunohistochemical examination. INTERVENTIONS After draining 4000 ml of pleural effusion by Pleurx catheter to relieve the pressure symptom, the patient underwent en-block resection by left posterolateral thoracotomy. A pedicle tumor originating in the left diaphragm was found, which was smooth, lobular, did not invade surrounding tissues or organs, and received blood supply from the left phrenic vessels. The diaphragm was successfully sutured without tension and did not require artificial reconstruction as the defect was small. OUTCOMES After 2 months follow-up, the left lung was restored to normalcy, and no pleural effusion or new occupying neoplasm was found in follow-up CT.
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Affiliation(s)
- Dan Liu
- Division of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu City
- Department of The First Surgery, The Traditional Chinese Medical Hospital, AnYue City, Sichuan Province, PR China
| | - Yun Wang
- Division of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu City
| | - Yu Zheng
- Division of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu City
| | - Han-Lu Zhang
- Division of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu City
| | - Zi-Hao Wang
- Division of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu City
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13
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Mekel G, Balshan E, Traupman F. Solitary fibrous tumour of the sigmoid colon mesentery. BMJ Case Rep 2019; 12:12/5/e228774. [PMID: 31068346 DOI: 10.1136/bcr-2018-228774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Solitary fibrous tumours (SFTs) are rare tumours arising from mesenchymal tissues. Despite of their more frequent occurrence in the pleura, SFT can present anywhere in the body. Only a few cases have been described arising from the mesentery. Most tumours have a benign nature; however, up to 20% of them can spread, most commonly to liver, lung and bone. Surgical excision including all surrounding tissues remains the treatment of choice; however, there is no consensus regarding the need for adjuvant therapies. We present a 79-year-old man with abdominal pain who was found to have a SFT in the mesentery of the sigmoid colon, treated with en bloc resection. A multidisciplinary team including surgeons, medical and radiation oncologists is recommended in the care of these patients.
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Affiliation(s)
- Gabriel Mekel
- Surgery, Saint Barnabas Medical Center, Livingston, New Jersey, USA
| | - Eli Balshan
- Pathology, Saint Barnabas Medical Center, Livingston, New Jersey, USA
| | - Frank Traupman
- Surgery, Saint Barnabas Medical Center, Livingston, New Jersey, USA
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Su HY, Tsai TH, Yang SF, Lee JY. Dumbbell-shaped solitary fibrous tumor of thoracic spine. Kaohsiung J Med Sci 2019; 35:517-518. [PMID: 30924290 DOI: 10.1002/kjm2.12063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/10/2019] [Indexed: 11/09/2022] Open
Affiliation(s)
- Hui-Yuan Su
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Hsin Tsai
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheau-Fang Yang
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Ying Lee
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Chest Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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