Solitary fibrous tumour of the face: a rare case report.

Solitary fibrous tumour is a rare mesenchymal neoplasm that most commonly involves the pleura. The diagnosis of solitary fibrous tumour is primarily histological. It consists of histological and positive immunohistochemical findings of CD-34 and vimentin. Recently, solitary fibrous tumour has been reported to occur in extrapleural soft tissues, such as the orbit, nasal cavity, abdominal cavity, parotid gland, scalp and neck. In an extensive review of the literature, we found no reports of solitary fibrous tumour arising in the facial soft tissue, other than in the parotid gland. This rare location of an uncommon lesion can lead to a confusing diagnosis. We report a case of solitary fibrous tumour originating in the temporal region of the face, and call for awareness of this tumour among plastic surgeons.     

Solitary fibrous tumour of the forearm. A rare tumour in an atypical site.

Solitary fibrous tumour (SFT) is a rare spindle cell neoplasm that usually arises from serosal surfaces. Although it is now increasingly recognized in extra-serosal locations, only two previous cases of SFT arising in an extremity have been reported. We describe another such case and review the literature regarding extra-serosal SFT.     

Solitary fibrous tumour of the kidney

Solitary fibrous tumours are relatively rare neoplasms initially described in the pleura. Such lesions are now reported in many extrathoracic sites. To our knowledge, only 8 cases have been reported in the kidney. All these cases were benign. We report a patient with a solitary fibrous tumour of the kidney with infiltration of the wall of the renal vein. Microscopic examination showed proliferation of spindle cells with a prominent vascular haemangiopericytoma-like pattern. Hypercellular areas were admixed with hyalinized collagenous zones. The neoplastic cells stained for vimentin and CD34. CD31 was negative. Biologically, we did not find any arguments for malignancy: the flow cytometric study showed diploid histograms, and immunostaining for p53 was negative.     

Solitary fibrous tumor of the prostate

Solitary fibrous tumor of the prostate is extremely rare. Only five cases have been reported to the present. A 36-year-old man presented to our hospital complaining of difficulty in urination. Retrograde urethrography and urethroscopy demonstrated intraurethral protrusion of the left prostatic lobe and complete obstruction of prostatic urethra. Magnetic resonance imaging demonstrated the prostatic tumor with prominent intravesical protrusion. Transrectal echo-guided biopsy was performed on the supposition of leiomyosarcoma of prostate. However, the tumor was diagnosed as benign fibrous tumor, so the patient underwent transurethral resection of left prostatic lobe for the purpose of improving urinary condition, avoiding retrograde ejaculation. Histologic examination revealed a dense proliferation of spindle cells with no nuclear atypia. No mitotic figure was seen. The pathologic diagnosis was benign solitary fibrous tumor of the prostate, because the tumor was positive for CD34 and negative for alpha-smooth muscle actin and desmin by immunohistochemical study. The patient remained well without regrowth of the tumor during the last six years.     

Solitary fibrous tumor of the prostate

We report a new case of a solitary fibrous tumor. It is a tumor which involve to genitourinary system unusual time, and it is exceptional in the prostate. Our patient began with bladder compression symptoms. Radiological studies showed polilobed mass that moved out the bladder although the could not show the pelvic organ was involved. The definitive diagnosis was made by histology and inmunohistochemestry of the surgical piece.     

Solitary fibrous tumour of the vagus nerve

We describe the complete removal of a foramen magnum solitary fibrous tumour in a 36-year-old woman. It originated on a caudal vagus nerve rootlet, classically described as the 'cranial' accessory nerve root. This ninth case of immunohistologically confirmed cranial or spinal nerve SFT is the first of the vagus nerve.     

Solitary fibrous tumor of the prostate

An extremely rare case of solitary fibrous tumor of the prostate is presented. The patient underwent a radical retropubic prostatectomy and has remained well with no evidence of recurrence during the last 18 months. This is the fifth reported case of such a lesion arising in the prostate.     

Solitary fibrous tumour of the retroperitoneum mimicking a renal mass

Authors report a case of solitary fibrous tumour of the retroperitoneum that mimicked a renal mass. A review of the literature and a discussion on the biologic meaning of the lesion are presented.     

Solitary fibrous tumour of the pleura: surgical treatment.

OBJECTIVE: Solitary fibrous tumours (SFT) of the pleura are rare tumours originated from the mesenchimal tissue underlying the mesothelial layer of the pleura. This tumours present unpredictable clinical course probably related to their histological and morphological characteristics. METHODS: Twenty-one patients affected by SFT of the pleura were referred to us for surgical resection from September 1984 to April 2000. They were 15 males and six females with median age of 51 (range 15--73) years. Nine patients (43%) were symptomatic and predominant clinical symptoms or signs were dyspnoea (19%), coughing (14.3%), chest pain (28.5%), finger clubbing (14.3%) and hypoglycaemia (14.3%). Hypoglycaemia was related to a pathological incretion of insulin-like growth factor 2 by the tumour. Chest radiograph and computed tomography of the chest revealed intra-thoracic homogeneous sharply delineated round or lobulated mass sometimes associated with ipsilateral pleural effusion (19%) or causing pulmonary atelectasis with opacification of the complete hemithorax (19%). Surgical excision required 14 posterolateral thoracotomies, six anterior thoracotomies and one video-assisted thoracoscopy. Thirteen tumours arose from visceral pleura and wedge resection was performed, seven tumours arose from parietal pleura and extrapleural resection was carried out without any chest-wall resection, one tumour growth within the upper left lobe and required lobectomy. Tumours weighted from 22 to 1942 g and measured from 22x12x8 to 330x280x190 mm. At cut section seven cases (34%) revealed focal necrosis and hemorrhagic zones and on light microscopy six cases (28.5%) were characterized by high mitotic count: characteristics related with uncertain clinical behaviour. Immuno-histochemical reactions were in all cases positive for CD34. RESULTS: In all our patients resections were complete. Paraneoplastic syndromes like hypoglycaemia and clubbing receded after surgery. No intraoperative or perioperative medical or surgical complications occurred. Median chest-drain duration timed 3 (range 2--5) days and median hospital stay was 5 (range 4--7) days. Perioperative mortality rate was 0%. Median follow-up was 68 (range 2--189) months: during this period patients were submitted to chest X-ray with 6-months interval to evaluate possible local recurrence. Only one patient experienced tumour recurrence after 124 months follow-up: the tumour was suspected after observation of finger clubbing. The tumour was detected and excised by redo-thoracotomy. CONCLUSIONS: Surgical resection of benign solitary fibrous tumours is usually curative, but local recurrences can occur years after seemingly adequate surgical treatment. Malignant solitary fibrous tumours generally have a poor prognosis. Clinical follow-up and radiological follow-up are indicated for both benign and malignant solitary fibrous tumours.     

Solitary fibrous tumour of the orbit: clinical and histological evidence

Solitary fibrous tumour (SFT) is rarely found in the orbit; it can occur within a wide age range (14–80 years). A case of a 59-year-old man with unilateral exophthalmos is presented. After CT and MRI investigations, the cause was seen to be an orbital mass that, after surgical removal, was diagnosed histologically as a solitary fibrous tumour. In the orbit, the SFT has a histological appearance identical to that of homonymous pleural lesion. It is characterized by alternating hypercellular and hypocellular areas, the collagen bundles having a keloid-type quality. Immunohistochemically, it showed a strong and widespread reactivity for CD68 and CD34. Correct diagnosis of this infrequent neoplasm needs not only clinical observation but also requires radiological examination (CT, MRI) and, above all, histological assessment. Various primary mesenchymal tumours of vascular and fibrohistiocytic type can mimic the symptoms of SFT, thus only the immunohistochemical profile and the ultrastructural features of the lesion allows it to be diagnosed definitively.     

Solitary fibrous tumour of the pleura: an ultrastructural and immunohistochemical study.

Solitary fibrous tumour of the pleura is a benign neoplasm differing from diffuse pleural mesothelioma. It was originally thought to be a variant of mesothelioma because it consists of a spindle cell stroma associated with branching tubular structures lined by cuboidal cells. In this study of two cases the tubular structures were lined with ciliated and non-ciliated cuboidal cells. Ultrastructurally most of the non-ciliated cells had the features of type II pneumocytes, while the stromal cells had all the characteristics of fibroblasts. Immunohistochemical staining showed the epithelial cells to be positive for both keratin and carcinoembryonic antigen, whereas the stromal cells were negative. The findings support the theory that these tumours are fibroblastic in origin, and that the biphasic pattern is due to entrapment of non-neoplastic bronchiolar and alveolar epithelial cells.     

Solitary fibrous tumour of the liver: case report and review of the literature

Background Solitary fibrous tumours (SFTs) of the liver are very rare entities. Although firstly described to be tumours of pleural origin, SFTs have been reported in various organs such as the meninges, orbit, upper respiratory tract, thyroid, peritoneum, retroperitoneum and soft tissues. Histologically, this tumour often shows alternating cellular and relatively acellular areas. The cellular areas show a wide variety of patterns, making it difficult for it to be differentiated from other mesenchymal tumours. Its immunohistochemical positivity for CD34 and vimentin is believed to be unique. Histiogenesis of SFTs, however, is not yet fully understood. They are known to be usually benign, with only few reports indicating their ability to metastasize.Patients and methods We review the literature on SFTs of the liver and report on the case of a 63-year-old female patient with a large SFT of the right liver.Conclusions Surgical resection seems to be the treatment of choice. Local recurrence is scarce. Due to the very limited number of cases, data regarding the long-term survival of patients are lacking.     

Solitary fibrous tumour of the pleura: Recurrence presented with severe clinical hypoglycaemia

Aim

To highlight an interesting case report of a rare cause of surgically treated hypoglycemia.

Background

Solitary fibrous tumors of the pleural are rare tumors, accounting for less than 5% of all pleural tumors. Interestingly, they are associated with hypoglycemia due to secretion of insulin growth factor II.

Case report

An 80 year old female who had been operated in the past for solitary fibrous tumor of the pleura in the right pleural cavity, developed severe symptomatic episodes of hypoglycemias. Her diagnostic workup revealed multiple ipsilateral intra-thoracic masses. She had been re-operated for and, indeed, multiple tumors were found and excised.

Results

The histologic identity of these tumors were in accordance with histology of the tumors which had been excised at her first operation.The patient recovered well and the hypoglycemic episodes have been completely subsided thereafter.

Conclusion

Hypoglycemia, which is considered a common though sometime severe symptom, needs a thorough diagnostic workup and when assessing it with an intrathoracic mass, solitary fibrous tumor of the pleural should always be kept in mind, since it is reversible cause.     

Solitary fibrous tumor of the liver: report of a rare case and review of the literature

Solitary fibrous tumor of the liver is extremely rare, with only 38 cases reported in the literature. We present one case of a SFT originating from the caudate lobe of the liver, treated by surgical resection and review the previous reported cases.     

Solitary fibrous tumor of central nervous system masquerading as meninigioma: Report of a rare case

IntroductionSolitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin that occurs most often in the visceral pleura. It rarely occurs in the central nervous system (CNS). If they occur intracranially, they are extra-axially located and develop from the meninges.Case ReportHerein, we present a case of SFT in a 45 years old female. MR imaging showed isointense to hypointense signal intensity, and marked enhancement. Microscopically, the tumors showed characteristic “patternless-pattern” architecture. Elongated tumor cells formed fascicles alternating with hypocellular densely collagenous stroma. Immunohistochemistry for STAT6, CD34, BCL2 and CD99 favours the definitive diagnosis of SFT.ConclusionIn general, complete surgical resection may offer the best chance of a favourable clinical outcome. Their biological features remain largely unknown. Hence, the clinical management and prognosis is often challenging due to the lack of comprehensive data.