Solitary fibrous tumor of the thoracic spine

Intraspinal solitary fibrous tumors are rare: to our knowledge, the literature reports only 27 cases. We present a histologically and immunohistochemically confirmed solitary fibrous tumor involving the intradural extramedullary compartment of the thoracic spine. Microsurgical gross-total resection was achieved. A definitive role for adjuvant treatments in this type of tumor has not been established and therefore, they were not used. The patient was well, without clinical or radiological recurrence, 18 months after surgery.     

前列腺孤立性纤维性肿瘤一例报告

孤立性纤维性肿瘤是一种罕见的起源于间充质梭形细胞的肿瘤,发生于前列腺者很少见。本院收治1例,年龄30岁,以排尿困难就诊,行经尿道前列腺钬激光剜除术,术后病理诊断为前列腺孤立性纤维性肿瘤,术后患者排尿症状得到明显改善。     

胸腔非典型孤立性纤维肿瘤1例

正患者男,43岁,2个月前无明显诱因出现胸闷、气促,偶有咳嗽、咳痰,近2天出现左侧胸痛。CT增强示左侧胸腔内下份见混杂密度肿块(图1),病灶中心层面大小约10.3cm×23.1cm,病灶与膈肌分界不清;增强后肿瘤呈不均匀强化。考     

肾孤立性纤维瘤1例报告并文献复习

目的 分析肾孤立性纤维瘤的临床病理特征及诊治方式.方法 回顾性分析我院诊治的1例肾孤立性纤维瘤的病理特征、临床表现、影像学检查、治疗方式和术后随访状况.结果 肾孤立性纤维瘤是肾脏较罕见的一种间叶性肿瘤,良性居多,少数为恶性.病理特征多为VIM(+)、CD34(+)、BcL-2(+)、CD99(+).影像学检查显示为类圆形、包膜完整的肿物,与周围组织界限清楚,CT增强后呈现不同程度欠均匀强化.本例患者行机器人辅助腹腔镜下肾部分切除术,术后病理诊断为肾孤立性纤维瘤(中间性),术后随访3月余,未见肿瘤复发、进展和转移.结论 肾孤立性纤维瘤属临床上较罕见的肿瘤,确诊主要通过病理诊断,治疗上首选手术切除肿瘤.     

Malignant solitary fibrous tumor with superior vena cava syndrome

Mediastinal solitary fibrous tumors, particularly those that are malignant, are rare. We report a case of malignant solitary fibrous tumor with superior vena cava syndrome and highly aggressive behavior. Postoperative radiotherapy was performed due to incomplete resection, but the tumor relapsed within 4 months. Gemcitabine-based chemotherapy was ineffective.     

Primary solitary fibrous tumor (SFT) in the retroperitoneum

BACKGROUND: Solitary fibrous tumor (SFT) is an infrequent but distinct neoplasm, which generally arises from submesothelial connective tissue in the pleura. SFT is rarely recognized in extrathoracic sites, and histologically identical conditions have also been reported in the retroperitoneum, although their pathophysiology has not been extensively investigated. METHODS: We present four cases of primary SFT in the retroperitoneum, and review 37 similar cases in the previous literature. RESULTS: About 40% of patients were asymptomatic, and 19.2% and 15.4% presented with an abdominal mass and urinary symptoms, respectively. The tumor size ranged between 2 and 26 (mean 9.1) cm. Sixty-three percent of tumors showed nonspecific development with haphazard distribution of bland short spindle or polygonal cells with or without collagenous bundles and stromal hyalinization. In 22.0%, hemangiopericytomatous appearance was seen. About 15% of cases showed histologically malignant characteristics. The tumor cells were immunoreactive for vimentin in all cases, CD34 in 91% and Bcl-2 in 86%. All tumors were excised, and in 85.4% of cases, tumors did not recur postoperatively for 6 to 48 months. No significant difference was found between the recurrence rate of histologically benign and malignant cases. Cases positive for both CD34 and Bcl-2 had no recurrence. CONCLUSIONS: The identification of SFT in the retroperitoneum is of importance because histopathological indicators of malignancy are not necessarily associated with clinical malignant potential in many cases of retroperitoneal SFT. Retroperitoneal SFT showing typical pathological features with expression of CD34 and Bcl-2 is associated with a favorable outcome following excision.     

Intrapulmonary solitary fibrous tumor with bronchial involvement: a rare case report in a child

Intrapulmonary solitary fibrous tumor is a very rare neoplasm. Our review of the English literature suggests that it has not previously been reported in children younger than 10 years. Herein, the occurrence of such a rare lesion invading the tracheobronchial tree is reported in a 7-year-old boy.     

Dumbbell-shaped chondrosarcoma that primarily developed in the cervical spine: a case report

There have been few reports describing dumbbell chondrosarcomas that primarily developed in the cervical spine; and among these cases even fewer can easily be diagnosed as chondrosarcoma. We report a 58-year-old man who complained of right cervical pain and swallowing difficulty without a particularly apparent cause. Magnetic resonance imaging (MRI) and computed radiography (CT) suggested a diagnosis of dumbbell tumor. ^99mTc HMDP bone scintigraphy and ²⁰¹Tl scintigraphy were negative, and surgery was performed assuming the presence of a neurogenic tumor. Intraoperative histopathological examination showed similar results. The postoperative histopathological diagnosis, however, was chondrosarcoma (grade II). Retrospective discussion regarding the diagnosis of the patient revealed that gadolinium-enhanced MRI was not appropriate for a precise diagnosis and that CT was more effective. We have thus experienced a patient with a rare dumbbell chondrosarcoma that primarily developed in the cervical spine for which a preoperative diagnosis was difficult.     

Malignant solitary fibrous tumor of the nasal cavity.

Solitary fibrous tumors (SFTs) are unusual mesenchymal tumors that were first described as primary spindle-cell neoplasms of the pleura. These tumors have been described in many other locations, including the urogenital system, orbit, mediastinum, and upper respiratory tract. Twenty-two cases of an SFT of the paranasal sinuses and nasal cavity have been reported, but none described a malignant SFT extending through the anterior skull base. A 70-year-old man had a 6-month history of unilateral left-sided epiphora and nasal obstruction. Computed tomography and magnetic resonance imaging showed a large left-sided nasal cavity mass with extension into the left extraconal orbit and intracranial extension through the left cribriform plate and ethmoid roof. The patient underwent preoperative embolization of the internal maxillary artery and a subsequent anterior craniofacial resection via a midfacial degloving approach and a left anterior craniotomy. Histopathological analysis of the specimen was consistent with a malignant SFT.     

Mediastinal solitary fibrous tumor with right diaphragm invasion: Report of a case

Mediastinal solitary fibrous tumors (SFTs) are rarely found in adults and there are few reports describing primary mediastinal SFT invading the diaphragm. We report the case of a 47-year-old woman with a large right inferior mediastinal SFT. Magnetic resonance imaging showed the tumor invading the right lower lobe of the lung and the right hemidiaphragm, with displacement of the inferior vena cava (IVC) and right lobe of the liver. Angiogram showed IVC stenosis. To our knowledge, this is the first report of complete resection of the tumor combined with right lower lobectomy of the lung and partial resection and reconstruction of the right diaphragm with a Dacron flap.     

A locally aggressive solitary fibrous tumor of the leg: Case report and literature review

INTRODUCTIONThe solitary fibrous tumor (SFT) is a rare soft tissue tumor with a substantially benign clinical behavior. However, malignant neoplasms with local recurrence or distant metastases have been reported.PRESENTATION OF THE CASEThe authors present a case of an aggressive SFT of the leg, in a 55 years old Caucasian man. Radiological, histological and molecular findings are reported. The differential diagnosis, therapy and outcome of this rare tumor are also discussed.DISCUSSIONAn extensive review of literature showed SFT's clinical behavior as substantially benign, anyway aggressive or malignant neoplasms have been described. The potential risk of local recurrence and distant metastasis thus suggests wide surgical resection and careful long-term follow-up. Differential diagnosis may be quite laborious as SFT can mimic a variety of benign and malignant mesenchymal tumors; immunohistochemical analysis for CD34, CD99, vimentin and bcl-2 is then mandatory.CONCLUSIONOur clinical experience confirmed that SFT may have an aggressive behavior, however, conservative surgical treatment may be successful in the long term.     

儿童椎管内外沟通性孤立性纤维性肿瘤1例

<正>患儿男,4岁,因"发现背部肿块2年余,逐渐增大"入院。查体:背部脊柱右侧见一肿块,表面皮肤完整无发红、无破溃,边界欠清晰,质稍硬,无压痛。MR检查:T12～L2上缘水平椎管左后份及椎管右后方见团块状等T1混杂短T2信号,DWI未见明显扩散受限,病灶跨椎管内外生长呈"哑铃状",相应水平脊髓受压向右前方移     

Solitary fibrous tumor in the cervical spine with destructive vertebral involvement: a case report and review of the literature

Introduction  Recently, solitary fibrous tumors occurring in spine-related lesions have been reported. However, the destruction of vertebral bodies by this type of tumor has not been reported. Materials and methods  A 71-year-old female presented with pain from a mass on the right side of her neck. Plain radiographs of the cervical spine showed collapse of the C5 vertebral body and dislocation of the C4 vertebral body. The MRI image showed a large mass surrounding C4 and C5, which had low signal intensity in the T1W image and high signal intensity in the T2W image. At first, resection of the tumor and spinal fusion was performed by anterior approach. Results  Histology revealed a solitary fibrous tumor with proliferating spindle cells. Immunohistochemistry showed positive stains for vimentin and CD34. One year postoperatively, a local recurrence manifested extensive destruction of the C4 and C5 vertebral bodies. Then, palliative surgery with posterior cervical instrumentation and radiation therapy were performed. Because the destruction proceeded and the rods were broken 2 years after, she underwent additional occipito-cervical instrumentation. Conclusions  This is the first report of a solitary fibrous tumor that involves the destruction of the spinal structure. An extensive destruction of the vertebral body by the solitary fibrous tumor needs to be aware in treating this tumor with spinal involvement.     

Monostotic fibrous dysplasia of a cervical vertebra

Summary Fibrous dysplasia has been frequently reported to involve the spine in the polyostotic form, but only rarely in the monostotic form of the disease. The present case demonstrates monostotic fibrous dysplasia of the fourth cervical vertebra. We present the plain radiographic, CT-scan, scintigraphy and histologic examinations. C3–C4 posterior and anterior arthrodesis was performed. The post-operative follow-up was satisfactory.     

Retroperitoneal malignant solitary fibrous tumor of the small pelvis causing recurrent hypoglycemia by secretion of insulin-like growth factor 2

A 28-yr-old man presented with recurrent reduced consciousness, generalized seizures of unknown etiology, recurrent hypoglycemia, psychomotor retardation, and grade 2 ectasia of the left kidney. Abdominal computed tomography (CT) and positron emission tomography (PET) scans demonstrated a well-circumscribed suprapubic pelvic mass, measuring 18 x 15 x 11 cm, with involvement of para-aortic lymph nodes and dilatation of the left ureter suggestive of an extragonadal testicular tumor. We excised the tumor by laparotomy, and it was confirmed to be a solitary fibrous tumor (SFT). After surgery and R0 tumor resection, the patient had no further evidence of hypoglycemia or of recurrence.     

Giant cell tumor in cervical spine

A giant cell tumor in the cervical spine of a 67-year-old man complaining of pain in the neck and occipital area is reported. Cervical x-ray films revealed a round destructive lesion in the vertebral body of the fourth cervical vertebra. On the plain cervical computed tomography scan, the most impressive finding was a soap-bubble appearance, which showed a linear high-density area in the mass lesion with destruction of the vertebral body. After embolizing one branch of the artery feeding the tumor, a radical operation was carried out via the anterior approach. The role of cervical computed tomography scanning and computed tomographic myelography in diagnosing and showing the extension of the giant cell tumor is discussed.     

Solitary fibrous tumor in the pelvic space

A case of a solitary fibrous tumor (SFT) of the pelvic space in a 64-year-old man is reported herein. Computed tomography (CT) of the pelvis showed a large mass enhanced heterogeneously left paracentral and posterior to the bladder and intimately associated with prostate. The site of origin of the mass could not be defined on CT because margins blended with the bladder, prostate, and rectum. A tumorectomy was performed and has remained well with no evidence of recurrence during the last 3 months. The tumor was 12.5×9.5×8.3 cm in size, solid with a fibromuscular capsule, and gray-tan in color. Histologically, the neoplasms were well circumscribed and composed of short spindle cells arranged without an obvious pattern. Immunohistochemically, these cells were strongly positive for CD 34 and negative for S-100, alpha SMA, and AE1/AE3.