四肢孤立性纤维性肿瘤14例临床分析

目的探讨四肢孤立性纤维性肿瘤(SFT)的临床特征和治疗转归。方法收集2010年1月至2015年1月14例四肢SFT患者的临床、影像、病理及随访资料,分析其临床表现、影像学特点、病理学特征、治疗方式及预后。结果14例患者中,男性7例,女性7例;中位年龄38岁(范围:26~81岁);均无疼痛症状;肿瘤分布于上肢4例,下肢10例;良性10例,恶性4例。SFT的影像学检查无特异性。免疫组化染色显示,STAT6均呈阳性,CD34阳性12例,CD99和Vimentin阳性11例,Bcl-2阳性10例。14例患者均接受手术切除治疗,4例恶性患者中3例行术前新辅助化疗和术后化疗。随访27~113个月,14例患者皆存活,其中1例局部复发并远处转移,1例远处转移。结论SFT可表现为浅表肿块,四肢SFT应在没有导致严重残疾的情况下行局部广泛切除,术后需长期密切随访。

Clinical analysis of 14 cases of solitary fibrous tumor localized in extremities

Objective To investigate the clinicopathological characteristics,treatment and prognosis of solitary fibrous tumor(SFT)in extremities.Methods From January 2010 to January 2015,the data of fourteen patients with SFT in extremities were analyzed.The clinical and follow-up data of fourteen patients were collected and their clinicopathological characteristics,treatment and prognosis were analyzed.Results Among the fourteen patients of SFT in extremities,7 cases were male and 7 cases were female with a median age of 38 years(range:26-81 years).All patients had no pain symptoms.Ten SFTs were in the lower limbs and four in the upper limbs.There were 10 cases of benign SFTs and 4 cases of malignant SFTs.The imaging findings of SFT were nonspecific.Immunohistochemical staining showed STAT6-positive cells in all cases,CD34-positive cells in 12 cases,Bcl-2-positive cells in 10 cases,CD99 and Vimentin-positive cells in 11 cases.All patients received surgical treatment.Three patients underwent preoperative chemotherapy and post-operative chemotherapy.The follow-up time ranged from 27 months to 113 months.During the follow-up,14 cases were alive.One patient developed local recurrence and distant metastasis,and one patient developed distant metastases.Conclusion SFT may present as a superficial mass.SFT in extremities should be extensively resected without causing severe disability.Long-term follow-up should be performed after surgery.