肾孤立性纤维瘤1例报告并文献复习

目的:探讨肾孤立性纤维瘤(SFT)的临床病理学特征。方法:对我院收治的1例肾SFT患者的临床资料进行分析,并复习相关文献。结果:本例患者因左侧腰痛1个月入院,术前诊断为左肾肿瘤,行根治性左肾切除术,术后病理诊断为肾SFT,术后随访1年,未见肿瘤复发转移。结论:肾SFT临床罕见,治疗方法以手术治疗为主,最终依靠病理学检查结合免疫组化染色确诊,大部分为良性肿瘤,但也有少部分肾SFT为恶性,术后需长期随访。     

肾孤立性纤维瘤1例报告并文献复习

目的提高对肾孤立性纤维瘤的认识,探讨其诊治方法。方法对1例肾脏孤立性纤维瘤患者临床资料进行分析,并结合文献复习。结果患者行左肾根治性切除术。病理诊断为肾脏孤立性纤维瘤。术后随访6个月无复发和转移。结论肾孤立性纤维瘤是一种较为罕见的肿瘤,诊断主要依靠组织病理学及免疫组织化学,手术切除为主要的治疗方法,术后需长期随访。     

膀胱孤立性纤维瘤1例报告并文献复习

目的:探讨膀胱孤立性纤维瘤(SFT)的临床病理特征、诊断及治疗方法。方法:回顾性分析1例膀胱SFT患者的的临床资料,临床及影像学诊断为膀胱肿瘤,在腰麻下行经尿道膀胱肿瘤电切术,术后出院。1个月后再次来我院复查,在全麻下行经腹腹腔镜下膀胱肿瘤部分切除术。结果:病理检查提示为梭形细胞肿瘤,免疫组织化学检查倾向于SFT。患者腹腔镜术后痊愈出院。结论:膀胱SFT是一种罕见肿瘤,其诊断主要依靠病理学及免疫组织化学检查,手术是其主要治疗方法。     

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.     

前列腺孤立性纤维瘤1例并文献复习

孤立性纤维瘤(solitary fibrous tumor,SFT)是一种少见的间叶源性肿瘤,1931年由Klemperer和Rabin首先命名[1].最初认为SFT起源于间皮细胞,好发于胸膜腔[2].随着对该肿瘤的深入研究发现可发生在胸膜腔以为的部位,但发生在前列腺罕见.本院于2018年11月收治1例,报道如下.     

前列腺恶性孤立性纤维瘤1例报告并文献复习

<正>前列腺孤立性纤维瘤临床罕见,国内仅见3例报道,其中恶性1例。我科于2012年收治1例,结合文献复习,报道如下。1临床资料患者男性,59岁,因排尿困难2年,加重1个月入院。     

无症状肾脏孤立性纤维瘤1例

<正>患者,女,77岁。因"发现腹部包块肿大1个月,体检示左肾占位病变"收住我院。病程中无腰痛及肉眼血尿等典型症状。专科检查:左肾区可触及大小约20cm包块,质地较硬,表面光滑,边界清楚,无压痛及叩击痛。彩超提示左肾巨大实质性占位病变,大小18cm×16cm,边界清楚;CTA提示左肾占位病变,大小约17.4cm×15.9cm×14.2cm,考虑为嫌色细胞癌可能。左肾积水,左肾静脉及下腔静脉受压。患者在全麻下行经腹左肾癌根     

前列腺孤立性纤维瘤术后复发1例报告及文献复习

孤立性纤维瘤(solitary fibrous tumor,SFT)是一种软组织肿瘤,主要发生在脏层胸膜,表现为与胸膜相连、界限清楚的孤立性肿块.近年来发现孤立性纤维瘤还可以发生在胸膜外的22个部位,发生于泌尿生殖系统罕见,发生于前列腺者目前国内报道仅有10例.本院收治1例,现报告如下. 男性,54岁.因进行性排尿困难1年,肉眼血尿伴不能排尿1d入住本院.查体:直肠指检前列腺中央沟消失,不能触及上缘,质韧、表面光滑、压痛、无结节.B超检查:前列腺增大,约5.0mm×5.5mm×4.5mm,双肾积水.查血清PSA 1.33 ng/ml.行经尿道前列腺电切术,术中见前列腺重度增生,中叶增生明显,突入膀胱,表面糜烂出血,切除前列腺组织105g.病理诊断:前列腺孤立性纤维瘤.随访3个月,复查膀胱镜一次,未见明显异常.3个月后再次出现肉眼血尿,急诊至本科,查盆腔CT:前列腺电切术后:膀胱内密度混杂,见不规则高密度影,可见血流信号,双肾积水.遂在全麻下行耻骨上经膀胱前列腺肿瘤切除术.     

肾孤立性纤维瘤的影像学诊断:附1例报告并文献复习

目的报告一例肾脏孤立性纤维瘤的影像表现,提高对少见肾脏肿瘤的认识。方法回顾性分析1例肾孤立性纤维瘤患者的临床、影像学及病理资料,并复习相关文献。结果该例患者无临床症状,静脉肾盂造影显示为良性病变,CT上肿瘤位于肾窦内,轮廓规整,与周围组织分界清,平扫为均匀等密度,增强后明显强化,以实质期最显著。病理上肿瘤为梭形瘤细胞,血管较丰富,免疫组化Vimentin、CD99、Bc1-2阳性。结论发生在肾的孤立性纤维瘤罕见,结合临床及影像学表现,鉴别诊断需考虑到该病的可能。     

前列腺孤立性纤维瘤二例报告

目的探讨前列腺孤立性纤维瘤的诊断和治疗.方法总结2例前列腺孤立性纤维瘤患者资料.例1 40岁,表现为进行性排尿困难,会阴部胀痛不适,B超示前列腺增大,周边整齐.血清PSA 1.92 ng/ml,尿流率呈下尿路梗阻尿流曲线.例2 56岁,主要症状为进行性尿频、尿急、夜尿增多,B超、CT提示前列腺不均匀增大,前列腺穿刺活检确诊后,患者拒绝手术转放射治疗后失访.结合文献复习讨论.结果例1行经尿道前列腺电切（TURP）,切除前列腺组织83 g,随访8个月,未见肿瘤复发,排尿通畅.例2失访.病理检查,2例肿瘤均由梭形细胞和胶原束构成,镜下见特征性黏液样变和血管外皮瘤样变.例1有丝分裂相为1个/10 HP,免疫组化：CD34（＋）,CD99（＋）,bcl-2（＋）,S-100（-）,SM-A（-）.病理诊断：前列腺孤立性纤维瘤.例2有丝分裂相为4个/10 HP.免疫组化：CD34（＋）,CD99（＋）,bcl2（＋）,CK（-）,S-100（-）,SM-A（灶性＋）,desmin（-）.病理诊断：前列腺孤立性纤维瘤（恶性）.结论前列腺孤立性纤维瘤是一种罕见肿瘤,确诊依赖病理学及免疫组织化学检查.主要治疗方式是TURP和前列腺根治术,良性病变预后好.     

Solitary fibrous tumor of the meninges: two new cases and review of the literature

BACKGROUND

Solitary fibrous tumor (SFT), a mesenchymal neoplasm originally described in the pleura has been more recently reported to arise in a number of other sites, including the meninges. Nowadays immunohistochemistry facilitates the otherwise problematic differential diagnosis with regard to other benign and malignant spindle cell neoplasms of the central nervous system.

METHODS

Two recently treated cases of meningeal SFT (one craniospinal, one spinal) are presented and discussed in the light of the present knowledge and a review of the literature.

RESULTS

Total resection was followed by complete recovery and both patients are presently asymptomatic and without evidence of disease. The microscopic and immunohistochemical profiles (CD 34, vimentin positive; S-100, EMA negative) were consistent with those of previously reported cases.

CONCLUSIONS

The majority of SFTs behave in a benign fashion and do not recur unless subtotally resected. Malignant variants may account for up to 37% of SFTs in other locations but have never been reported to occur in the meninges. Meningeal SFTs are to be considered a new pathological entity. Wider use of immunohistochemical screening should enable the determination of their real incidence; larger series and longer follow-up will provide conclusions about their treatment and prognosis.     

下肢孤立性纤维性肿瘤影像学表现 (附2例报告及文献复习)

目的分析下肢孤立性纤维性肿瘤（SFT）的影像学表现。方法报告2例经病理证实的下肢SFT的影像学表现,并复习相关文献。2例患者均接受MR检查,1例接受X线检查。结果2例病变均主要位于大腿股二头肌内,MR多表现为边界清楚的椭圆形或类圆形肿块,T1WI呈等低或等信号,T2WI信号混杂,可表现为高、稍高和低信号;增强扫描多呈不均匀强化,肿瘤实质强化明显。X线平片1例未见骨质破坏。结论下肢SFT影像学表现有一定的特点,MR是其最佳检查方法。     

Large solitary fibrous tumor of the kidney: report of two cases and review of the literature.

Solitary fibrous tumors are spindle cell neoplasms frequently arising in the serosal surface as well as a variety of other sites. We report two cases of large solitary fibrous tumor arising in the kidney, clinically thought to be renal cell carcinoma, in 41- and 72-year-old men. Although large in size (13.0 and 14.0 cm in greatest dimension, respectively), both lesions were well circumscribed and composed of a mixture of spindle cells and dense collagenous bands with no areas of necrosis or cystic changes noted macroscopically or microscopically. Immunohistochemical studies revealed reactivity for vimentin, CD34, collagen IV, and bcl-2 protein in both cases, with no staining for keratin, S-100 protein, or muscle markers, confirming the diagnosis of solitary fibrous tumor of the kidney. Solitary fibrous tumor of the kidney is rare but may present as a large mass that may be clinically confused with carcinoma or sarcoma.     

Extensive solitary fibrous tumor of the retropharyngeal space

BACKGROUND: Solitary fibrous tumor (SFT) is a rare neoplasm whose histologic diagnosis poses significant problems in differential diagnosis. Although most of these neoplasms arise at the level of the pleura, there have also been reports of extrapleural origins. The most frequent localization in the head and neck region is in the nasal cavity. METHODS: We describe the case of an 81-year-old patient with an SFT that arose in the retropharyngeal space. Symptoms were solid food dysphagia associated with modest dyspnea. RESULTS: Physical examination revealed the presence on the posterior pharyngeal wall of an apparently circumscribed, multilobed mass, which was compact in consistency and partially obstructed the upper aerodigestive tract. After radiologic assessment to carefully evaluate its size and relationship to surrounding structures, the tumor was surgically removed. CONCLUSIONS: The importance of immunohistochemical findings in the histologic differential diagnosis are discussed. Follow-up plays a crucial role in evaluating the possible recurrence of such tumors, because parameters for determining their aggressiveness are still controversial.     

Open partial nephrectomy for tumor in a solitary kidney: experience with 400 cases

PURPOSE: We present a series of 400 patients with tumor in a solitary kidney who underwent open surgical partial nephrectomy performed by a single surgeon (ACN) with a primary focus on postoperative long-term kidney function. MATERIALS AND METHODS: A total of 400 patients with sporadic nonfamilial kidney tumors in a solitary kidney underwent open partial nephrectomy between 1980 and 2002. In 323 patients (81%) the contralateral kidney had been surgically removed, while the remaining 77 (19%) had a congenital solitary kidney. Renal insufficiency was present preoperatively in 184 patients (46%). Adverse risk factors for partial nephrectomy were present in a large percent of patients. Intraoperative and postoperative parameters were evaluated at a mean followup of 44 months. RESULTS: In the overall series 5 and 10-year cancer specific survival was 89% and 82%, respectively. Surgical complications occurred in 52 patients (13%), most commonly urinary leakage. Early postoperative renal function was achieved in 398 patients (99.5%). Only 2 patients required permanent dialysis postoperatively. Satisfactory long-term renal function was achieved in 382 patients (95.5%). A total of 18 patients had progressed to renal failure a mean of 3.6 years after surgery. Patient age, the amount of renal parenchyma resected, a congenitally absent or atrophic contralateral kidney and the time of contralateral nephrectomy were noted to be significantly associated with postoperative renal function. CONCLUSIONS: Open surgical partial nephrectomy can be safely performed in patients with tumor in a solitary kidney. Long-term cancer-free survival with the preservation of renal function can be reliably expected in most of these cases.     

Spinal solitary fibrous tumor: seventh reported case and review of the literature

We present the clinical, radiological, and pathological features of a solitary fibrous tumor in the spinal cord. This case is the seventh spinal solitary fibrous tumor in the literature. The tumor caused clinical symptoms in a 70-year-old female, which indicated compression of the spinal cord. Magnetic resonance imaging showed an intradural extramedullary mass at T3 vertebral level. Surgically, the tumor was firm, in an intradural extramedullary location and attached to the dura. Histologically, the tumor was composed of spindle cells in a collagen-rich matrix but exhibited regional variations. CD34 and vimentin were diffusely positive during immunohistochemical stain testing. The tumor displayed no positive staining for epithelial membrane antigen, cytokeratin, S-100 protein, smooth muscle actin or desmin. The Ki-67 labeling index was low. Solitary fibrous tumors have been found in a variety of locations suggesting that a solitary fibrous tumor has a mesenchymal origin. This rare tumor should be considered in the differential diagnosis of spinal tumors.     

Giant solitary fibrous tumor of the pleura

Primitive neoplasms of the pleura are uncommon. Solitary fibrous tumor of the pleura (SFTP) is a benign variety of primitive pleural tumor, which is usually asymptomatic and discovered as an incidental finding. However, these tumors can sometimes become locally aggressive and can even be life-threatening. The treatment of choice is surgical resection. We report a case of SFTP in a 78-year-old woman with no relevant history, who presented with marked respiratory insufficiency and who required extended posterolateral thoracotomy to achieve complete resection of an SFTP weighing 2 kg.