Abstract
Solitary fibrous tumor (SFT) is a rare stromal neoplasm and usually occurs in the thoracic cavity. We here report a case of retroperitoneal SFT with prominent calcification. A 64-year-old man presented with an incidentally detected retroperitoneal mass in the right upper abdomen. Imaging tests indicated an integrally calcified mass. The lesion was observed for 2 years and laparoscopically resected according to the patient’s wish. Microscopically, the mass was mostly occupied by calcification and proliferous spindle cells were scattered with positive CD34 expression. We diagnosed morphologically benign SFT and the patient remained disease-free 1 year after the excision. There has been no report of such integrally calcified SFT. Retroperitoneal SFT is difficult to make a preoperative diagnosis, and careful follow-up after the excision is recommended because morphological malignancy does not always correspond to clinical malignancy.
Highlights
Solitary fibrous tumor (SFT) is known as an uncommon mesenchymal neoplasm
We considered that the lesion mainly consisted of calcification and diagnosed large peritoneal pearl body or sponge-induced granuloma due to the past appendectomy
One of the 2 cases in which p53 was immunohistologically positive was dead of the disease. These results indicate that retroperitoneal SFT is quite difficult to diagnose and can be clinically malignant morphological examinations yield benign findings and negative immunostaining of CD34 or positive immunostaining of p53 can be signs of clinical malignancy
Summary
Solitary fibrous tumor (SFT) is known as an uncommon mesenchymal neoplasm. It mainly develops in thoracic cavity but extrathoracic SFTs have been reported. Case presentation A 64-year-old Japanese man without any symptoms had a medical checkup, and abdominal ultrasonography revealed a mass of the right upper abdomen with acoustic shadow. He had hypertension and underwent appendectomy for appendicitis by McBurney’s incision at 13 years old. SFT was incidentally detected without any symptoms, imaging inspection provided extremely atypical findings as any retroperitoneal neoplasms including SFT, and a precise preoperative diagnosis was difficult. The marked calcification was extremely unusual but the scattered tumor cells provided typical structures of SFT with positive immunostaining of CD34 and were considered to be morphologically benign. 2014, Toniato [18] 2004, Kunieda [16] 2015, Maki [The present case] 2009, Trabelsi [35] 2000, Morimitsu [26] 2001, Clayton [28] 2004, Kume [30] 2008, Shin [34]
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