Hepatic Solitary Fibrous Tumor Research Articles

Superior Identification of Metastatic Lesions by 68 Ga-FAPI-46 PET/CT Than 18 F-FDG PET/CT in Hepatic Solitary Fibrous Tumor.

Solitary fibrous tumors (SFTs) are fibroblast tumors that occur mainly in the pleura. Hepatic SFT with skeleton metastases was rarely documented. In this case, we report the contrast-enhanced CT, 18 F-FDG, and 68 Ga-FAPI-46 PET/CT findings of a rare hepatic SFT with bone metastases. 68 Ga-FAPI-46 PET/CT showed much higher tumor-to-background contrast of hepatic tumors and revealed more metastatic bone lesions than 18 F-FDG PET/CT. This case demonstrated the superiority of 68 Ga-FAPI-46 PET/CT over 18 F-FDG for identifying metastatic lesions in malignant SFTs. This observation may add information on the benefit of FAPI PET/CT in SFT staging.

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.

Solitary Fibrous Tumor of the Liver: Case Report

Introduction: Solitary fibrous tumor (SFT) of the liver is a rare mesenchymal tumor. Most patients are asymptomatic. Clinic-radiological features are non-specific. Definitive diagnosis of SFT is usually made based on the histological features and immunohistochemistry data of the resected specimen. In this case report, we describe the case of an elderly female who presented with a large mass in the left lobe of the liver with normal level of tumor markers and atypical radiological findings. The patient successfully underwent resection of the tumor and the diagnosis was confirmed on histopathology. Methods: A 81-year old woman with abdominal pain for the past 2 months. Examination revealed a large mass palpable in the epigastric region. CT and MRI showed a 25×16 cm-sized hypervascular mass arising from the left lobe of liver. The mass displace stomach, the transverse colon and cause a chronic obstructive pancreatitis due to the compression. The level of tumor markers was within the normal limits: AFP 3.3 ng/ml, CEA 2.3 ng/ml, and CA 19-9−27 U/ml. Liver functions were in the normal range. Based on the atypical imaging findings biopsy of the lesion was done. It was suggestive of solitary fibrous tumor. Since the lesion was resectable, surgery was planned. Trans-arterial chemoembolization was done before the surgery without incidences. The patient underwent left lateral sectionectomy. Intraoperatively, a solitary large tumor arising from the segment II and III of the liver was identified and no evidence of distant metastasis. The postoperative course was uneventful. The tumor measured 19 ×14 x9,5 cm-sized, with an external well delimited surface. Microscopic examination showed atypia with spindle cells and collagen bundles between the tumor cells. On IHC, the tumor was positive for STAT6, CD34, Bcl2, and focal and patched positive for CD34 y CD99. There was no evidence of recurrence on follow-up for 7 months. Conclusion: SFT of the liver is a rare entity. Most patients are asymptomatic, but in some cases, abdominal fullness and palpable masses are present. Definitive diagnosis is made based on the histological features and immunohistochemistry data of the resected specimen. IHC remains the most important tool for conclusive diagnosis of SFT. Complete surgical excision is the treatment for hepatic SFT. Follow up is advised as some of the patients with benign tumors on initial histological examination developed distant metastasis later.

A Giant Solitary Fibrous Tumor of the Liver with Metastasis and Local Recurrence

Solitary fibrous tumor (SFT) is a rare type of mesenchymal neoplasm. Although the majority of SFTs are benign, some cases have shown characteristics of malignant neoplasms. Weight loss, fatigue, and upper abdominal bloating are the main signs of these lesions. Clinical and radiographic features are not sufficient for the diagnosis of hepatic SFT and the definitive diagnosis depends on histopathological sampling and immunohistochemistry. One of the main issues in the diagnosis of this tumour is the ability of this tumour to grow to large sizes. A 69-year-old male presented to the clinic 2 years earlier with episodes of hypoglycemia and loss of consciousness. The symptoms improved after receiving glucose. The patient diagnosed as rare solitary fibrous tumour of the liver, a giant (10 × 10 cm in diameter) round and well-defined lesion in the left lobe of the liver which was obvious in magnetic resonance imaging (MRI). Surgery is the most common line of treatment for this disease and there is no evidence regarding the effectiveness of other approaches. According to the scarcity of hepatic SFT, long-term prognosis in these patients is highly challenging. Here, we present the case of a 69-year-old male patient with hepatic SFT with metastasis and local recurrence. In the very rare malignant form of liver solitary fibrous tumour which is surgically unresectable, liver transplantation is one of the potential options but maybe not amenable due to the malignant behaviour of the disease. Role of debulking surgery is also not clear in this situation.

Ex situ hepatectomy and liver autotransplantation for a treating giant solitary fibrous tumor: A case report.

A solitary fibrous tumor (SFT) is a rare mesenchymal tumor. Ex situ hepatectomy and liver autotransplantation are novel methods for the treatment of complicated liver tumors, for example, those involving vascular structures, including the inferior vena cava, which are unresectable by conventional approaches. The present study describes a rare case of a massive hepatic SFT in a 32-year-old female who underwent ex situ hepatectomy and liver autotransplantation to achieve a radical resection. The surgery was without complications. Post-operative histopathological and immunohistochemical examinations revealed an SFT of the liver. The patient was discharged 29 days after the surgery with fully recovered liver function. The routine check-up 3 months after surgery indicated normal liver function and no evidence of recurrence. Additionally, an exhaustive review of available literature was performed to provide a complete overview of the current status of SFTs. In summary, the present study found that ex situ hepatectomy and liver autotransplantation are suitable surgical techniques for treating a giant SFT, as well as other liver neoplasms that are considered unresectable by conventional surgery.

A rare case of primary hepatic solitary fibrous tumor associated with pregnancy

Purpose: To describe a case of histologically and immunohistochemically confirmed primary hepatic solitary fibrous tumor (SFT) associated with pregnancy. Case Report: A 40-year-old Caucasian woman G3P1021 with history of oral contraceptive use and no other known significant past medical history delivered via C-section in November of 2012. Two months post delivery, she noted that her abdomen did not decrease in size and sought medical attention. As part of the work-up, an abdominal MRI revealed a 15.9 cm mass centered in segment 4b of the liver with extension into segments 5 and 8 within the right lobe. In addition, an exophytic component extending inferiorly from the liver into the right mid abdomen was noted. The patient underwent an uncomplicated hepatic segmentectomy with cholecystectomy. Grossly, the tumor consisted of a firm tan-white well-circumscribed and partially encapsulated mass. Histologically, the tumor was composed of cytologically bland spindle cells with a patternless architecture with hypocellular and hypercellular areas embedded within a collagenous fibrous stroma with occasional dilated branching thin-walled blood vessels. The tumor showed no infiltrative margins or necrosis and a mitotic count of 1/10HPF. Tumor cells were strongly and diffusely positive for CD34, BCL-2, and vimentin; weakly positive for STAT6 (nuclear distribution); and focally positive for CD99 and β-Catenin. In addition, estrogen and progesterone receptors (ER and PR) were also performed and showed positive staining. The diagnosis of SFT was confirmed. To date, 36 months post-resection, our patient has been followed with imaging, showing no evidence of residual or recurrent disease. Conclusions: Primary hepatic SFT is exceedingly rare and even more so in association with pregnancy. Positive immunohistochemical staining of tumor cells for progesterone and estrogen receptors may indicate hormonal stimulation as a driver of neoplastic cell proliferation.

An update on primary hepatic solitary fibrous tumor: An examination of the clinical and pathological features of four case studies and a literature review

BackgroundPrimary hepatic solitary fibrous tumor is a rare neoplasm that originates in the submesothelial tissue of the liver and is frequently misdiagnosed because of its rarity and unfamiliar characteristics. AimTo analyze, summarize and update the clinical and pathological features of primary hepatic solitary fibrous tumor. MethodsWe systematically extract the clinical data of 4 cases from the relevant medical records, analyze the macroscopic, histological and immunohistochemical features and review the 59 previously reported cases in the English literatures. ResultsThe patients’ mean age 50.75 years (range, 49–52 years), and the gender ratio was 1:1. The tumors ranged in size from 2.3 to 12.0cm (average diameter, 7.85cm). The tumors were composed of spindle cells with oval, fusiform or banded nuclei that were arranged in bundled, storiform or peculiar random patterns. Mitosis and hemangiopericytoma-like vessels were occasionally observed. Immunohistochemically, three cases were positive for Signal transduction and activator of transcription 6, cluster of differentiation 34, B-cell lymphoma-2 and vimentin but were negative for nervous, muscular and hepatocellular markers. Hepatic lobectomy was performed in all cases, and one patient received adjuvant chemotherapy simultaneously. One patient suffered two recurrences without metastasis, and the remaining patients experienced favorable outcomes. ConclusionsA consensus on the essential and definite diagnostic criteria for primary hepatic solitary fibrous tumor must be reached in a timely manner. Signal transduction and activator of transcription 6 is a highly sensitive and specific immunohistochemical marker for primary hepatic solitary fibrous tumor.

Hepatic Solitary Fibrous Tumor Presenting as Severe Hypoglycaemia: A Case-Report

We report a case of a patient presenting with profound insulin-independent hypoglycaemia. A large hepatic leasion was identified and surgically resected. Histology confirmed a 17.5 cm hepatic solitary fibrous tumour. The clinical and biochemical presentation is consistent with IGF-II mediated hypoglycaemia.

Solitary fibrous tumor of the liver: Report of two cases and review of the literature

A solitary fibrous tumor (SFT) of the liver is a rare neoplasm of mesenchymal origin. 59 cases have been reported in the literature. We report 2 patients who presented with a hepatic solitary fibrous tumor. The first case is a 65-year-old man who presented with an accidental finding of a large mass in the left liver. Biopsy revealed an SFT and left hepatectomy was performed. The diagnosis was confirmed by histopathology. The second case is an 87-year-old woman who presented with disturbances in her liver function tests. A Computed Tomography (CT) scan showed a large mass in the right liver. Surgery was contraindicated because of the patient's poor general condition. A biopsy was done and SFT was diagnosed histopathologically. SFT are usually benign but the risk of malignant transformation always exists, which mandates surgical resection as the optimal management of these tumors. However, because of the small sample size and the rarity of the entity, it is difficult to define the evolution, the risk factors and the malignant potential of these tumors.

18F-FDG PET/CT Imaging of Malignant Hepatic Solitary Fibrous Tumor

Solitary fibrous tumor of the liver was rarely documented. F-FDG PET/CT imaging of malignant hepatic solitary fibrous tumor in a 49-year-old male patient was reported. The multifocal hepatic lesions demonstrated avid FDG uptake. FDG PET/CT might be potentially useful in the differentiation of benign and malignant solitary fibrous tumor.

同時性肝内転移，膵転移を伴った肝原発solitary fibrous tumorの1例

症例は56歳の男性で，検診で指摘された肝機能異常の精査目的で高次医療機関を受診した．腹部CTでは，肝前区域を主座とする20 cm径の腫瘤性病変を認め，肝外側区域と膵体部に転移病変が疑われた．肝生検にて孤立性線維性腫瘍（solitary fibrous tumor；以下，SFTと略記）と診断され，手術加療目的で当院へ紹介となった．治療は腫瘍縮小と出血制御を目的にTAEを先行処置した後に，拡大中央2区域切除，外側区域部分切除にて肝主病巣と肝内転移巣を切除し，9か月後に膵頭部新規病変を含む膵転移巣を切除した．術後補助療法は施行せず，現在30か月無再発生存中である．肝原発悪性SFTはまれであり，また膵転移を伴った症例は自験例のみである．遠隔転移を有する悪性症例についても病巣の完全摘除により長期無再発生存が可能であることが示唆された．

Malignant solitary fibrous tumor involving the liver

Solitary fibrous tumors are predominantly benign and are most commonly found in the thoracic cavity and pleura; while reports exist in the literature of malignant solitary fibrous tumors and those located in extrathoracic organs, these cases are considered extremely rare. Herein, a case is reported of a malignant solitary fibrous tumor involving the liver that was diagnosed and treated in a 62-year-old woman. The patient presented with complaints of upper abdominal pain and unintentional weight loss. Computed tomography scan of the abdomen revealed a remarkably large mass, measuring 15 cm × 10 cm × 20 cm, which appeared to be unrelated to any particular organ. The intraoperative finding of a wide communication with the left liver suggested hepatic origin, and served as an indicator for tumor resection via left hemihepatectomy. The diagnosis of solitary fibrous tumor and its malignant nature was confirmed by histological and immunohistochemical examination of the resected tissues. Hepatic solitary fibrous tumor is very rare, and surgery remains the mainstay of treatment. Due to limited reports of such tumors in the literature, little can be said about the benefit of adjuvant therapy and prognosis for the rare cases with malignant histological findings.

Hepatic solitary fibrous tumor: Report of a rare case

Solitary fibrous tumor (SFT) of the liver is an extremely rare neoplasm of mesenchymal origin. In the English literature, less than 40 cases of SFTs of the liver have been reported. The present case concerns a 34-year-old female who presented to us with complaint of dyspepsia. On examination, there was hepatomegaly. On ultrasound examination, an SOL in the liver was detected. Large tumor measuring 14.5 × 10 × 8 cm was resected. Microscopic evaluation of the tumor showed a well-circumscribed, low to moderately cellular tumor demonstrating spindle- and fibroblast-like cells within the collagenous stroma. Immunohistochemistry revealed diffuse strong cytoplasmic immunopositivity of CD34, Bcl2, and vimentin. A diagnosis of a benign SFT was given. The patient remained well 4 years after surgery. SFT is a rare mesenchymal neoplasm that occasionally involves the liver in adult patients. Most SFTs are benign, but some may have malignant histological features. With less than 40 reported cases in the literature, little can be said regarding its natural history or the benefits of adjuvant radio chemotherapy. Complete surgical resection remains the cornerstone of its treatment.

Tumeur fibreuse solitaire du foie

Solitary fibrous tumor (SFT) is commonly found on serosal surfaces, and is rarely localized in the liver. There are benign and malignant variants of hepatic SFT. We report a new case of benign SFT. Our patient, a 63-year old woman, who has been followed for 5 years for an asymptomatic liver mass, was admitted for abdominal pain. Ultrasonography (US), CT, MR Imaging and angiography showed the liver mass with typical imaging features, situated in the right hepatic lobe with blood supply from the hepatic artery. Histopathological examination demonstrated a highly vascularized tumor, composed of short spindle cells alternating with hypocellular collagenous regions, with a hemangiopericytoma-like vascular pattern. The immunohistochemical staining was positive for CD 34. Tumor resection was performed. Follow-up 8 years after the resection showed no tumor recurrence or metastasis, thus confirming the initial diagnosis of benign SFT.