جستجوی مقالات مرتبط با کلیدواژه « solitary fibrous tumor » در نشریات گروه « پزشکی »

Solitary fibrous tumors (SFT) are the rare mesenchymal tumors originally described in the pleura. SFT of breast is even rarer and to the best of our knowledge about 35 cases are reported to date, including only six malignant SFT cases.

Casepresentation: 

We report a case of a 52-year-old lady with a large left breast mass involving all the quadrants. The tumor was diagnosed as malignant SFT in a core needle biopsy which was later confirmed on the resection specimen.

Herein, we describe the approach and importance of optimal utilization of immunohistochemistry for diagnosing such rare tumors of the breast, particularly, when clinical presentation, radiology and fine needle aspiration cytology are incongruous.Copyright © 2024. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non-Commercial 4.0International License,which permits copy and redistribution of the material in any medium or format or adapt, remix, transform, and build upon the material for any purpose, except for commercial purposes.INTRODUCTIONThe solitary fibrous tumor is one of the rare mesenchymal origin tumors with an incidence of <0.1/100,000 people.1,2 This tumor tends to pose diagnostic challenges due to similarity in clinical, radiological and histological features with several more common soft tissue tumors like synovial sarcoma, leiomyosarcoma, phyllodes, malignant peripheral nerve sheath tumor (MPNST), etc. The tumor was previously reported to primarily occur in pleura which is still the most common site accounting for 70% of the cases. However, now it is known to occur at any anatomical sites with a varying spectrum of histological features. Histologically, it ranges from hypocellular to hypercellular tumors to anaplastic SFT with sarcomatous transformation.3 Fibroblastic cell is considered as the cell of origin in these tumors. Historically, SFTs are sub-classified into three groups: i) Benign (local disease); ii) not otherwise specified (usually not metastatic); and iii) malignant.4The general criteria adopted for malignant SFTs include a large tumor size, mitotic rate of ≥4/10 high-power fields (HPFs), nuclear pleomorphism, and necrosis. Demiccoet al. proposed a modified four-variable risk stratification model for development of metastasis in solitary fibrous tumors based on age, tumor size, necrosis and mitotic count into three risk classes of low, intermediate, and high risk.5 The diagnosis as well as risk stratification of SFT at unusual sites like the breast are very demanding and not possible on clinical and radiological examination. Accurate diagnosis requires a combined evaluation of clinical, pathological, immunohistochemical and molecular features together. Herein, we report a case of malignant SFT in a 52 year-old lady with a focus on diagnosis.CASE PRESENTATION A 52-year-old lady presented with a progressively enlarging lump in the left breast over the last 12 Case ReportOpen Access

Background and importance: 

Cervical laminectomy and fixation (PCF) is a surgery used in the treatment of symptomatic patients who are resistant to medical therapy, though it can have serious complications affecting patient outcomes.

This case report describes a rare occurrence of a solitary fibrous tumor (SFT) at the site of a previous cervical laminectomy in a 45-year-old female patient. Following non-surgical treatment for paresthesia and weakness in the upper limbs due to cervical stenosis, the patient underwent cervical laminectomy from C3-6 without instrumentation.

One year after surgery, the patient presented with severe pain and swelling at the surgical site, and radiological evaluation revealed a large mass in the para-vertebral muscular layer. The mass was removed, and microscopic evaluation revealed a typical SFT. The patient underwent an extension of laminectomy and fusion with lateral mass screw, and follow-up at six months showed no recurrence of the tumor.

A Solitary Fibrous Tumor (SFT) is a soft tissue tumor that appears exceedingly rare in the parotid gland. The literature review suggested that approximately 12%-22% of these cases behave aggressively. Besides, only 4 cases of histological malignant parotid gland SFT are reported in the English literature. We presented a 65-year-old cigarette-smoker man with a fix and tender mass over the left parotid and submandibular areas. On physical examination, the marginal branch of the facial nerve was paralyzed. The left total parotidectomy and neck dissection levels 1 and 2 were performed with preoperative embolization procedure and adjuvant radiotherapy for the patient. The results of the follow-up examination were unremarkable after 11 months. In this case report, we aimed to increase awareness on SFTs, although rare, among clinicians and pathologists. Accordingly, it should be considered in the differential diagnosis of soft-tissue tumors in the major salivary glands for better management.

A solitary fibrous tumor of the urinary bladder is an extremely rare type of mesenchymal tumor. We present a case of an 85-year-old woman with a large (14.5×10.7×10.1 cm) protruding intravesical mass detected by computed tomography (CT) and magnetic resonance imaging (MRI), which was proven to be a solitary fibrous tumor through histopathological examination. The clinicopathologic and radiological features are here discussed, along with a review of the published literature on this topic. Solitary fibrous tumors of the urinary bladder are more common in men (76%), with a peak incidence in people 40–60 years old. Most such tumors show heterogeneous intensity with a complete capsule. A decrease in the T2WI signal with an increase in collagen tissue content and gradual enhancement on CT/MRI images are their main features. Most such tumors are positive for CD34 under immunohistochemistry (100% in 24 available cases). The majority of tumors (88%) studied have been non-malignant and most patients (95.5%) showed favorable prognosis after a long-term follow-up.

Solitary fibrous tumors (SFTs) more commonly arise in the pleura but recently, they have been reported in several extrapleural organs. Urogenital localization is rare, and only small numbers of cases of paratesticular SFT have been reported. An 81-year-old male with a history of colon carcinoma and complaint of testis swelling was referred for evaluation of a right paratesticular mass. Physical examination revealed a 2 cm oval-shaped paratesticular mass and herniation of intestinal loops in the right inguinal region after cough and Valsalva maneuver. An ultrasound examination was found in the upper pole of testis a well-defined hypoechoic mass in favor of testicular mass. It also revealed moderate to severe bilateral hydrocele and calcified wall in favor of benign lesion. In conclusion, SFT should be considered in the differential diagnosis of paratesticular masses and needs to be confirmed by IHC. CD34 and CD99 biomarkers are useful for confirmation of SFT.

Solitary fibrous tumor (SFT) of prostate is an unusual type of mesenchymal neoplasm that can elicit a benign or malignant phenotype. It represents a diagnostic challenge as it can simulate poorly differentiated adenocarcinoma and various mesenchymal neoplasms of prostate. We report a case of prostate SFT in a 54-year-old patient, which was clinically misdiagnosed as nodular hyperplasia of prostate with cystitis. However, on follow-up, he was not relieved by the designated treatment. Furthermore, he complained of exacerbation of symptoms and consequently, had to undergo open prostatectomy. Based on histopathological and immunohistochemical (IHC) assessment, a diagnosis of SFT of the prostate was rendered. Additionally, we have discussed the histological mimics of SFT and the diagnostic and prognostic importance of IHC while evaluating such lesions.

Schwannoma is a peripheral nerve sheath tumor originating from schwann cells. It is the most common neurogenic tumor of the posterior mediastinum. Pleural effusion is a rare presentation of benign schwannoma and it is mainly related to malignant tumors. Histologically, schwannoma as well as solitary fibrous tumor should be considered as a differential diagnosis of spindle cell lesions.

Here, we report a case of an asymptomatic 61-year-old female misdiagnosed as solitary fibrous tumor of posterior mediastinum which was revealed to have blood stained pleural effusion during the video-assisted thoracic surgery. Eventually pathological study and immunohistochemistry profile of the tumor was reported as benign schwannoma.

This report indicates that benign schwannoma can be accompanied by bloody pleural effusion and it also emphasizes the role of immunohistochemistry in the diagnosis of biopsy specimen of spindle cell lesions.

A 60-year-old male presented with dyspnea and chest pain. He was referred with massive bulky mass. A mass in the left lung was observed using chest X-ray (Figures 1).  A computed tomography scan of the chest showed a mass on the left lung with complete lung collapse Figures 2 (A, B). The needle biopsy was performed and the case was diagnosed with solitary fibrous tumor. Subsequently, the patient underwent complete resected open thoracotomy. In our case, the mass dimension was 50 × 35 cm weighting 5.600 gr Figures 3 (A,B).

Solitary fibrous tumor (SFT) is an uncommon neoplasm of mesenchymal origin, and it most often occurs in the pleura. Mammary gland involvement is extremely rare in this disease. Herein, we report a case of SFT that presented as a slowly growing large mass in the breast of a 64-year-old man. On ultrasonographic examination, the mass was oval and circumscribed with heterogeneous echogenicity and increased intralesional blood flow. Moreover, the mass showed hard elasticity as revealed by shear-wave elastography (SWE), which has not been reported in English literature so far. We also briefly review the literature on the radiologic findings. Because of the nonspecific imaging findings and difficulty in its differentiation from other soft tissue tumors, complete excision with detailed immunohistochemistry is essential.

Primary pleural neoplasms are rare entities compared with the pleural involvement by metastatic carcinoma.
The current study aimed at investigating the complete spectrum of pleural neoplasms and differentiating between them with the aid of immunohistochemistry (IHC).
Consecutive pleural biopsy specimens positive for a neoplasm, both primary and metastatic, were included in the study. Diagnosis or a differential diagnosis was suggested on histopathology confirmed by a panel of IHC markers such ascytokeratin (AE1/AE3), epithelial membrane antigen (EMA), vimentin, calretinin, CD34, CD99, SMA, bcl2, S100, CK7,CK20,TTF1,GCDFP, HMB45, LCA, synaptophysin, chromogranin, and naspsin.
A total of 35 cases of pleural neoplasms included 15 (42.9%) primary pleural neoplasms and 20 (57.1%) metastatic carcinoma. Synovial sarcoma, malignant mesothelioma (MM), and solitary fibrous tumor (SFT) accounted for 14.2%, 11.4%, and 8.5% of metastatic cases, respectively. Epithelioid sarcoma (ES), neuroendocrine carcinoma, and inflammatory myofibroblastic tumor were less common, each contributing to 2.9% of pleural neoplasms. Among the 20 cases of metastatic carcinoma, 13 were from the lung and 7 from the breast. Lung neoplasms metastasizing to the pleura were adenocarcinoma (n=12) and atypical carcinoid (n=1).
Analysis of histopathological pattern along with a panel of appropriate IHC markers distinguished the rare entities of pleural neoplasms essential to determine the prognosis and treatment modality.

Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal tumor. It can originate from abdominal soft tissue which is extremely scarce, and liver indeed is super scant site. SFT liver (SFTL) is mostly benign, but it can be malignant and aggressive with metastases and a potential of recurrence. Hypoglycemia is the least reported feature which is resistant to medical management and will be resolved following resection of a SFT of liver.
Case Report: A 67-year-old man presented with episodes of sudden onset loss of consciousness since 3 months before first visit. He was a previously healthy farmer, without any other complaint or past medical history except for episodes of sever hypoglycemia. Laboratory testing revealed hypoglycemia which was temporarily response to glucose infusion, hypoglycemia was refractive, and whole physical examination and laboratory tests were done and there were no abnormal findings. With probability of finding something such as insulinoma or any other tumor that secreted insulin or insulin-like growth factors, a magnetic resonance imaging (MRI) was performed and revealed an enhancing giant round and well-defined lesion in left lobe of live.

We here present the first case of malignant SFTL presenting with hypoglycemia and metastasis to soft tissue as inguinal bulging 2 months after resection of liver mass, but this particular type of tumor needs more evaluation and investigation.

Solitary fibrous tumor has a wide spectrum of histopathologic features and many tumors show similar microscopic features. This similarity poses diagnostic challenges to the pathologists and immunohistochemical analysis is required in many cases. Moreover, it is a rare entity in orofacial region which consequently would make its diagnosis more challenging in oral cavity. The knowledge of various microscopic patterns of this tumor contributes to a proper diagnosis and prevents unnecessary treatment. This study reports a case of solitary fibrous tumor in the retromolar pad area and discusses its various histological features and differential diagnoses.

Solitary fibrous tumor (SFT) is a mesenchymal tumor which is most commonly seen in the pleura; however it can be seen in other organs such as the meninge, gastrointestinal tract, soft tissue, bone, and skin. SFT should be differentiated from other mesenchymal tumors in these organs. Immunohistochemistry plays a pivotal role for the histopathologic diagnosis of this tumor. Currently, new markers have been introduced which has been very useful for definite diagnosis of SFT along with other markers in each specific location which are negative in SFT.
Here we review the reported positive and negative immunohistochemical markers of SFT in the English literature with the emphasis on the useful markers in each specific organ. We explored the English literature from 1990 through 2015 via PubMed, Google, and Google scholar using the following search keywords: Solitary fibrous tumor, Solitary fibrous tumor and immunohistochemistry, Solitary fibrous tumor and diagnosis, Solitary fibrous tumor and histogenesis, Solitary fibrous tumor and prognosis, Solitary fibrous tumor and hemangiopericytoma, Solitary fibrous tumor and differential diagnosis, Solitary fibrous tumor and markers.
The most important and valuable positive markers in SFT are CD34, CD99, Bcl-2 and STAT-6.There are consistently negative markers in this tumor as well, used according to the tumor location, such as EMA and S100
Immunohistochemistry is very useful for the diagnosis of solitary fibrous tumor and for its differentiation with other spindle cell mesenchymal tumor in different locations.

Calcifying fibrous tumor (CFT) is a rare mesenchymal tumor, affecting children and young adults with a predilection for the soft tissue and the abdominal cavity. CFT of the tubular gastrointestinal tract is very rare with less than 20 cases of gastric CFTs reported in English literature. This benign hypocellular fibrosclerotic calcifying lesion can resemble other spindle cell tumors particularly sclerosing gastrointestinal stromal tumor of the stomach. Differentiating between these lesions is particularly important for prognostic and therapeutic purposes. Herein a case of gastric calcifying fibrous tumor incidentally detected during bariatric surgery in a 27-year-old woman is described, with a discussion on its clinicopathological features and differential diagnoses.

Herein, we report the F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) findings of a benign solitary fibrous tumor (SFT) of the kidney. The patient was a 63-year-old woman with a mass in the right kidney (10×9.7 cm), incidentally found on CT images. The CT scan showed a lobulated tumor arising from the hilum of the right kidney. The tumor consisted of two components with different patterns of enhancement. Most of the tumor demonstrated moderate enhancement from the corticomedullary to nephrographic phase. A small nodular component at the caudal portion of the tumor showed avid enhancement in the corticomedullary phase and rapid washout in the nephrographic phase in contrast-enhanced CT. FDG-PET/CT was performed and showed weak FDG accumulation (SUVmax=2.30 and 1.91 in the main and small caudal components). Although renal cell carcinoma was preoperatively diagnosed, histopathological examination revealed renal SFT, with no malignant potential. Therefore, when a renal tumor with contrast-medium enhancement and low FDG accumulation is demonstrated, SFT should be considered as a differential diagnosis in addition to renal cell carcinoma.

Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that is usually located in the pleural cavity, but it can arise in any part of the body. SFTs can develop in the extremities, in the head and neck region, meninges, orbits, thoracic wall, mediastinum, pericardium, peritoneum, retroperitoneum, pelvis, adrenal glands, liver and urogenital system.. A 29-year-old female, was admitted in the gynaecology and obstetrics unit, for suspected pelvic tumor. CT scan showed a mass with hypervascular behavior and adherent to the uterus. The patient underwent laparoscopic resection of the mass. Abdominal exploration revealed a 5 cm mass, rising from the right iliac retroperitoneum above the pelvic space. The tumor was resected totally laparoscopically. The final histological findings were consistent with benign SFT. There were few mitotic cells (2 × 10 HPF) and a positivity for CD34 BCL2 and actin 1A4 and negative for CD117, desmin and CD99; MIb1 was < 5%.. This is the first case of SFT of the retroperitoneum removed laparoscopically. The laparoscopic approach is useful for the advantages of minimally invasive surgery especially in case of peduncolate tumor as the case reported..

Solitary Fibrous Tumors (SFTs) are rare primary pleural neoplasms which have recently been reported in extra-thoracic sites. In this report, solitary fibrous tumor arising in an intra-thoracic goiter with no evidence of cervical mass in a 74-year-old obese man who was found to have a large superior mediastinal mass with tracheal deviation on Chest X-Ray is presented.

Orbital solitary fibrous tumor (SFT) is a rare tumor and orbits are a very uncommon site. It is mostly noted to arise from mesenchymal structures like pleura and peritoneum. The diagnosis of orbital SFT cannot be made with certainty on clinical or radiological evaluation alone and requires immunohistochemical studies for confirmation. Orbital SFT’s usually show an indolent clinical course and a complete cure can usually be achieved with complete resection. We describe clinical presentations, radiological and operative findings, and pathological features of a patient with orbital SFT along with a review of literature.