A rare case of solitary fibrous tumor of the liver and highly differentiated rectal adenocarcinoma

Solitary fibrous tumors (SFT) are rare spindle cell mesenchymal neoplasms of presumably fibroblastic origin with undefined malignancy potential and rare metastasis. Their most frequent localization is in the pleura, where they have been first described. The incidence of solitary fibrous tumors localized in liver is extremely low. The clinical picture of SFT is nonspecific and is not due to the anatomical location of the tumor and it's size.In the majority of cases these tumors are benign. However, a number of them still may have signs of malignancy: an aggressive course with possible local recurrence and distant metastasis. The main method of treatment of hepatic solitary fibrous tumor (as well as SFT of other localization) with it's resectability is surgery. Radical removal of the tumor in the majority of cases leads to recovery. Subsequently, the operated patients should be subjected to strict dynamic observation with regularity as in malignant neoplasms (MN).The importance for chemotherapy and radiation therapy in the treatment of hepatic solitary fibrous tumor has not been determined in clinical guidelines to date.There are isolated reports of the use of chemotherapy or radiation therapy for the treatment of cases when tumor resection is not radical or there are signs of malignant neoplasm.In literature, there are numerous reports of a combination of a solitary fibrous tumor of any localization with malignant neoplasms of other organs in the same patients.In this report, we represent a clinical case of a 64-year-old woman, who had a solitary fibrous tumor of the liver and highly differentiated rectal adenocarcinoma. The patient underwent resection of the first segment of the left lobe of the liver. After a month and a half, transanal excision of the villous tumor of the rectum. The pathologic and immunohistochemical examination of the liver tumor revealed a malignant solitary fibrous tumor. After researching villous tumor of the rectum - a highly differentiated adenocarcinoma with a depth of invasion of the submucous layer of the intestinal wall up to 1/3 (T1sm1 according to Kikuchi). During dynamic observation for twenty-five months after the operation, the patient has no signs of tumor recurrence and metastasis.

A Novel Cause of Bowel Obstruction in a Patient with Long-Standing Crohn’s Disease

Solitary fibrous tumors are rare tumors of mesenchymal origin. Although most often observed in the lung pleura, they have been reported in varied extrapleural sites. A 70-year-old male with complicated Crohn’s disease presented with 3 days of nausea, emesis, constipation, and abdominal pain. Computed Tomography (CT) demonstrated mucosal thickening of the middescending colon, consistent with fibrosing stricture. Surgical excision revealed an unusual, 5 cm mass originating in the subserosa. Histopathology of the lesion was notable for a proliferation of cells with spindle and stellate-shaped nuclei and no appreciable mitotic figures, which extended into the muscularis and submucosa. Immunohistochemistry was STAT6 nuclear positive and cytoplasmic CD34 positive, diagnostic for solitary fibrous tumor (SFT). In this case, the SFT infiltrating into the muscularis propria and subserosa caused the stricture and bowel obstruction. This illustrates that while fibrosing strictures are usually the etiology of bowel obstruction in the setting of Crohn’s disease, other rare possible causes should be considered.

The Relationship Between The Apparent Diffusion Coefficient and The Ki-67 Proliferation Index in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma

Objiective: This study evaluated the value of the apparent diffusion coefficient (ADC) in distinguishing grade II and III intracranial solitary fibrous tumors /hemangiopericytomas and explored the correlation between ADC and Ki-67. Methods The preoperative MRIs of 37 patients treated for solitary fibrous tumor/hemangiopericytoma (grade II, n = 15 and grade III, n = 22) in our hospital from 2011 to October 2020 were retrospectively analyzed. We compared the difference between the minimum, average, maximum, and relative ADCs based on tumor grade and examined the correlation between ADC and Ki-67. Receiver operating characteristic curve analysis was used to analyze the diagnostic efficiency of the ADC. Results There were significant differences in the average, minimum, and relative ADCs between grade II and III patients. The optimal cutoff value for the relative ADC value to differentiate grade II and III tumors was 0.998, which yielded an area under the curve of 0.879. The Ki-67 proliferation indexes of grade II and III tumors were significantly different, and the average (r = -0.427), minimum (r = -0.356), and relative (r = -0.529) ADCs were significantly negatively correlated with the Ki-67 proliferation index. Conclusions ADC can be used to differentiate grade II and III intracranial solitary fibrous tumors/hemangiopericytomas. Our results can be used to formulate a personalized surgical treatment plan before surgery.

Giant Solitary Fibrous Tumor of the Pancreas: A Case Report and Review of the Literature

Background: Solitary fibrous tumors (SFTs) originating from the pancreas are rare, only 23 cases have been reported so far. Here, we report the largest one, which has its unique treatment characteristics.Case report: A 42-year-old woman was admitted to the hospital with abdominal pain and abdominal mass, and the preoperative diagnosis was unclear. As the mass was rich in blood vessels, she underwent partial pancreatectomy after embolizing part of the blood vessels by preoperative intervention, which, at final pathology, showed spindle and oval cell proliferation and featured the presence of hemangiopericytoma-like blood. Immunohistochemistry showed cytoplasmic expression of CD34 and nuclear expression of STAT6, and mitotic activity was lower than 4 mitoses/10 high-power fields (HPFs). At the end, she was diagnosed with pancreatic SFT. The postoperative recovery was uneventful and she was alive and free of disease after 8 months.Conclusion: The diagnosis of SFT of the pancreas needs to be done very cautiously. Surgical treatment and postoperative follow-up are more reasonable methods at the moment.