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

Abstract

We present a case report of a giant solitary fibrous tumor (SFT) with a review of the literatureand discuss its biological features and diagnosis. A 43-year-old man presented to our emergency department with abdominal pain and distension with an evolution of two days. Contrast-enhanced computed tomography (CT) showed a large, well-circumscribed semisolid mass (12 cm x 10 cm x 12 cm) localized in the pancreatichead. The histological diagnosis obtained by endoscopic ultrasound-guided trans-duodenal tumor biopsywith fine-needle aspiration showed proliferating short spindle-shaped cells, suggesting a mesenchymal neoplasia of low grade. We proceeded to aWhipple surgical technique. The histopathological study of the resected tumorconfirmed proliferating spindle-shaped cells in the tissue, and one mitotic figure was observed in 10 high-power fields (HPFs). Immunostaining was positive for CD34 and STAT-6. The histological diagnosiswas a malignant pancreatic SFT. In the six months posterior to the surgical procedure, the patient has been free of recurrent disease. Preoperative diagnosis is difficult and requires comprehensive evidence including clinical, immunohistochemistry, and histological features. Since there are currently no recognized best practices, we advise total surgical excision and careful clinical monitoring.