Solitary Fibrous Tumor Research Articles

A Radiomics Model for the Differentiation of Intracranial Solitary Fibrous Tumor/Hemangiopericytoma and Meningioma Based on Multiparametric Magnetic Resonance Imaging.

Although the imaging findings of intracranial solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) and meningioma are similar, their treatment and prognosis are quite different. Accurate preoperative identification of these two types of tumors is crucial for individualized treatment. The aim of this study was to develop a radiomics model for the differentiation of intracranial SFT/HPC and meningioma based on multiparametric magnetic resonance imaging (mpMRI). A total of 99 patients from July 2012 to July 2018 with histologically and immunohistochemically confirmed SFT/HPC (n = 40) or meningiomas (n = 59) were retrospectively analyzed. A total of 1118 features were extracted based on its image shape, intensity and texture features. The logistic regression (LR) and multi-layer artificial neural network (ANN) classifiers were used to classify SFT/HPC and meningioma. The predictive performance was calculated using receiver operating characteristic curves (ROC). We found significant difference in terms of sex between the SFT/HPC and meningioma group (χ2= 4.829, P < 0.05), but no significant difference was found in age (P > 0.05). The most significant radiomics features included five shape and four first-order level features. For the LR classifier, the prediction accuracy of SFT/HPC was 71.0% and meningioma was 78.7%. For the ANN classifier, the prediction accuracy of SFT/HPC was 83.9% and meningioma was 80.9%. Both of the two classifiers achieved a high accuracy rate, but ANN was better. Radiomics features, especially when combined with an ANN classifier, can provide satisfactory performance in distinguishing SFT/HPC and meningioma.

Analysis of imaging features of rare tumors in nasal cavity and paranasal sinus

Objective:To explore the imaging features of rare tumors of nasal cavity and sinuses, and to improve the understanding of these diseases, thereby aiding clinical diagnosis and treatment. Methods:The CT and MRI findings of 79 cases of rare neoplasm of nasal cavity and sinuses confirmed by pathology were retrospectively analyzed, and the imaging features were summarized. Results:Among the 79 cases, there were 16 cases of neuroendocrine carcinoma, most showing expansive and infiltrative bone destruction without hyperosteogeny and sclerosis. The sphenoid sinus exhibited a "pigeon" shape. In 28 cases of malignant melanoma, MRI signals were diverse, typical signals were rare, but mixed signals were more common. In 12 cases of rhabdomyosarcoma, MRI enhancement mostly showed "grape-like" enhancement and partial ring enhancement; There were 10 cases of olfactory neuroblastoma, the lesions were consistent with the distribution area of olfactory mucosa, most of them were lobulated, marginal nodules, and "flower ring" enhancement, and 2 cases grew across intracranial and external, with multiple cystic lesions and surrounding flaky edema bands. In 5 cases of solitary fibrous tumor, Benign tumors had regular shape and uniform density, while malignant tumors had irregular shape and uneven density, The enhancement was obviously uneven and showed a "pattern" change. There were 2 cases of sarcomatoid carcinoma, both with lobed appearance, uneven density, lamellar low-density shadow, and osteolytic bone destruction. In 4 cases of schwannoma, the enhancement showed obvious inhomogeneous enhancement. One case showed cystic necrosis, one case showed calcification, and the surrounding structure was compressed without damage. There was 1 case of neurofibroma, with many cystic components, low signal separation and compartmentalized enhancement. One case of paraganglioma showed moderate enhancement in the arterial phase and progressive enhancement in the venous phase, accompanied by significant swelling bone destruction. Conclusion:Rare tumors of nasal cavity and paranasal sinuses have distinctive imaging features. CT and MRI can effectively show the extent of the lesions and the degree of infiltration into adjacent tissues and organs, which is helpful for early clinical diagnosis and staging. However, definitive diagnosis still depends on pathology and immunohistochemistry.

Giant Solitary Pulmonary Fibrous Tumor: Case Report

The giant pulmonary solitary fibrous tumor is a mesenchymal tumor of rare fibroblastic differentiation, preferably intrathoracic and intraoral. Not associated with specific risk factors. Non-specific clinical presentation and slow growth. The present case is of a 54-year-old patient with dyspnea on medium exertion with the presence of abolished left vesicular murmur. He developed refractory hypoglycemia leading to Doege Potter syndrome. A total occupying mass was evident in the left chest on computed axial tomography. A modified approach was performed by sternotomy plus left thoracotomy to improve exposure and hemodynamic control with access to the tumor’s nutritional vessels and total tumor excision. Histopathology revealed a heavier tumor reported in the medical literature. Microscopy presence of mesenchymal neoplasia composed of spindle-shaped and oval cells and positive immunohistochemistry of giant solitary pulmonary fibroma.

Solitary fibrous tumor of the pleura

Solitary fibrous tumor of the pleura

Recurrent orbital solitary fibrous tumor: clinical and pathological insights from a Case Report and literature review

Recurrent orbital solitary fibrous tumor: clinical and pathological insights from a Case Report and literature review

Resection of pleural solitary fibrous tumors with distinct feeding vessels arising from the descending aorta: a case report

BackgroundPleural solitary fibrous tumors (pSFTs) are rare mesenchymal pleural tumors with rich vascularity. Surgical resection is the cornerstone of pSFTs treatment, requiring careful preoperative imaging to delineate lesion extent and vascular supply including contrast-enhanced computed tomography and other examinations depending on its size and characteristics.Case presentationThe patient was a 34-year-old female with a mass measuring approximately 67 × 42 × 65 mm in the left posterior mediastinum. Intraoperatively, the mass demonstrated rich vascularity. Two veins originating from the abdominal cavity entered the lower pole, one converged from the superior pole, draining into the brachiocephalic vein. Additionally, two arteries arose directly from the descending aorta, while several veins drained into the intercostal veins. In response to unexpected intraoperative vascular findings, vascular clips and silk threads were used to ligate them. Subsequently, the tumor was successfully dissected, with approximately 600 ml of blood loss recorded during the 4-hour surgery. The patient exhibited a satisfactory postoperative recovery, and follow-up spanning over six months revealed no indications of recurrence or metastasis.ConclusionsWe firstly present a case of successful resection of a pSFT in a 34-year-old woman with a distinct feeding vessel arising from the descending aorta and describe the related surgical procedures. This case highlights preoperative evaluation of mass vascularity based on contrast-enhanced computed tomography. When blood supply is challenging to clarify, angiography can offer additional details, especially for giant pSFTs. Despite this, thorough intraoperative exploration remains essential to detect unexpected vessels. Appropriate interventions should be customized based on the vascular origins and the surrounding anatomical structures.

Solitary Fibrous Tumor of the Liver Disguised as Hepatocellular Cancer

Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin characterised by NAB2 and STAT6 genes fusion. SFT occurs in one of 300.000 patients who seek medical attention. Incidence rate of liver SFT is unavailable due to a minor number of existing observations. In most cases, diagnosis of SFT is incidental. Yet, in 5% of cases, it manifests as paraneoplastic syndromes. Differential diagnosis using CT and MRI is complicated due to unspecific pattern of the neoplasm. This paper presents a clinical case of a 58-year-old patient who applied for a consultation at A.V. Vishnevsky National Medical Research Center of Surgery. Due to non-specificity, the laboratory and instrumental examination findings did not allow making a correct diagnosis at the preoperative stage. Histological examination findings helped to finally diagnose solitary fibrous tumor. Based on the data obtained, we can draw a conclusion about the imperfection of existing diagnostic options and the need to identify specific criteria for solitary fibrous tumor diagnosis.

Thoracic solitary fibrous tumors with small cell features: A clinicopathological and immunohistochemical analysis of 5 cases

Five cases of thoracic solitary fibrous tumor (SFT) with small cell features are presented mimicking a neuroendocrine neoplasm. The patients were four men and one woman aged 43 to 74 years who presented with symptoms of chest pain, cough, dyspnea or hemoptysis. Two tumors were intrapulmonary neoplasms, while three were pleural-based. Grossly, the tumors ranged in size from 4 to 6 cm and were white and solid; in two tumors necrosis was apparent. Histologically, they were characterized by a cellular proliferation composed of small cells with round nuclei and inconspicuous nucleoli. The cellular proliferation in some areas had a subtle nested pattern, while in other areas the tumor showed extensive sclerosis and small vessel proliferation. Cellular pleomorphism was not marked and the mitotic activity varied from 1 to 5 mitotic figures per 10 high power fields. Microscopically, necrosis was observed in two cases and focally present in one. Immunohistochemical stains showed tumors cells universally negative for pancytokeratin; in the two pulmonary cases, focal staining for synaptophysin, CD56, and INSM1 was observed. The unexpected lack of expression of pancytokeratin led to additional analysis revealing positive staining with CD34 and STAT6 confirming a diagnosis of SFT. Clinical follow-up showed tumor recurrence in one patient while three patients remained alive and well after a period of 12 to 20 months. The current cases highlight an unusual variant of SFT that may be confused with other small cell tumor entities, such as neuroendocrine or neuroectodermal tumors, especially when originating in the thoracic cavity.

Orbital Solitary Fibrous Tumor in a Commercial Airline Pilot.

BACKGROUND: In the literature, central serous retinopathy (CSR) accompanying solitary fibrous tumors (SFT) in a pilot has not been reported. In airline pilots, mass effect-related symptoms such as diplopia, ptosis, etc., seen with orbital tumors may endanger flight safety.CASE REPORT: A 62-yr-old male commercial airline pilot presented with blurred vision in the right eye. He had been receiving treatment for 2 mo because of CSR. His visual acuity was 10/20 in the right eye and 20/20 in the left. During examination, ptosis and exophthalmos were noticed in the right eye. Ocular movements were free in all cardinal directions and there was downward displacement in the right eye. There was no diplopia. Magnetic resonance imaging revealed a 1.5- to 2-cm well-defined contrast-enhancing mass in the lateral extraconal orbit. His medical flight certificate was suspended for 3 mo due to decreased visual acuity and superior visual defect. Superior orbitotomy was performed without any complication. Ptosis and CSR had regressed 1 wk after surgery. All systemic and ophthalmological examinations met aviation medical certificate requirements. He returned to flight on the condition of being checked every 3 mo. At the 1-yr follow-up, there was no sign of recurrences of SFT or CSR.DISCUSSION: SFTs are slow-growing neoplasms that can manifest symptoms related to mass effect. In the current literature, there are no reported cases of the coexistence of orbital SFT and CSR or pilots able to resume flight duties only 1 wk after a successful orbitotomy and tumor resection surgery.Altinbas M, Ozpınar A, Akbaba M, Nacaroglu SA, Sargolzaeimoghaddam M, Sargolzaeimoghaddam M. Orbital solitary fibrous tumor in a commercial airline pilot. Aerosp Med Hum Perform. 2024; 95(6):333-336.

Clinical analysis of 12 cases of solitary fibrous tumors in nasal cavity, sinuses and skull base

Objective:To summarize and analyze the clinical manifestations, diagnosis and management and prognostic features of solitary fibrous tumor（SFT） in nasal cavity, sinus and skull base. Methods:The clinical data of 12 patients with STF from nasal cavity, sinus and cranial base admitted to the Affiliated Hospital of Qingdao University from April 2014 to January 2022 were retrospectively analyzed, including 4 patients admitted to the department of Otolaryngology head and neck surgery and 8 patients admitted to the department of skull base surgery The clinical characteristics, diagnosis, management and prognosis were analyzed. Results:Twelve patients were included in this research, including 7 males and 5 females. All patients received surgical treatment, and 4 patients also received postoperative adjuvant chemoradiotherapy. After follow-up for 12-60 months, 4 patients with adjuvant radiotherapy and chemotherapy had a good prognosis, and among 8 patients who did not receive radiotherapy and chemotherapy, 6 patients had good prognosis and 2 patients showed relapse. Four patients with a history of recurrence of SFT after surgery were admitted to our hospital for surgical treatment, in which 1 patient had relapse after surgery, and none had metastasis. Nasal cavity and sinus to skull base SFT is rare. The most effective treatment for this disease is surgical resection, and postoperative adjuvant chemoradiation and long-term follow-up can achieve a better prognosis. En bloc resection is the key to treatment success.

Diagnostic Work-Up in the Histological Verification of A Rare Solitary Fibrous Tumor

Diagnostic Work-Up in the Histological Verification of A Rare Solitary Fibrous Tumor

Expression of fibroblast activation protein in intrathoracic solitary fibrous tumor

PurposeFibroblast activation protein (FAP) is a serine integral membrane protease, the expression of which has been confirmed in various cancer types. Solitary fibrous tumors of the pleura (SFTP) are rare mesenchymal fibroblastic neoplasms. We present a case of 18F-labeled FAP inhibitor ([18F]FAPI-74) PET imaging and its correlation with histological FAP expression and review an SFTP series at our institution in relation to the extent of FAP expression. MethodsThis retrospective study included 13 patients who underwent surgery between March 2011 and December 2022 at our institute. One of the patients also underwent [18F]FAPI-74 PET imaging. We semi-quantitatively evaluated FAP expression in SFTPs using immunohistochemical staining and H-scores. ResultsNine of the 13 patients were male, with a median age of 64 years (range, 28–79 years). The median tumor size was 6.6 cm (1.1, 16 cm). In the pathological findings, expression levels of Ki67 were 1–5% in 12 of 13 cases. Furthermore, FAP expression was observed in all patients, and the median H-score was 160 (range, 10–280). The H-score of FAP expression in two of the 13 patients was low (10 in both), and that in two of the 13 patients was high (240 and 280). The SUVmax value of [18F]FAPI-74 PET was 3.57 in a patient in whom the H-score of FAP expression was 180. ConclusionsSFTPs expressed FAP to varying degrees in different patients and the [18F]FAPI-74 PET results in one patient reflected FAP expression in the tumor tissue.

Imaging characteristics and diagnosis of primary middle mediastinal tumors

Objectives: To investigate the proportion of different histological types and CT enhanced imaging features of primary middle mediastinal lesions in order to improve the understanding of these tumors and the accuracy of preoperative diagnosis. Methods: Retrospective analysis was conducted on 84 patients with primary middle mediastinal lesions and clear histological classifications diagnosed and treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2012 to December 2022. Clinical, imaging, and pathological data were collected and classified according to tumor histological classifications. CT imaging manifestations such as tumor location, size, morphology, edge, boundary, internal components, enhancement characteristics, and surrounding tissue invasion were evaluated and recorded. Results: The histological types of the primary middle mediastinal lesions from the 84 patients included mesenchymal tumors, anterior intestinal cysts, giant lymph node hyperplasia, substernal goiter, neuroendocrine carcinoma, lymphohematopoietic system tumors, and mesothelioma, accounting for 28.6%, 27.4%, 14.3%, 3.6%, 11.9%, 9.5%, and 4.8%, respectively. Mesenchymal tumors included peripheral nerve sheath tumors, vascular tumors, adipogenic tumors, solitary fibrous tumors, and synovial sarcoma, accounting for 54.2%, 20.8%, 12.5%, 8.3%, and 4.2%, respectively. The above tumors had diverse imaging manifestations and specific imaging features. Mature fat were found in 3 cases of liposarcoma; Calcification was observed in 2 cases of thyroid nodules and 7 cases of giant lymph node hyperplasia; Enhanced scanning showed significant enhancement in 2 cases of solitary fibrous tumors, 3 cases of thyroid nodules, and 11 cases of giant lymph node hyperplasia; Mediastinal large lymph nodes was observed in 6 cases of lymphoma and 3 cases of mesothelioma; High invasiveness was observed in 4 cases of mesothelioma and 9 cases of neuroendocrine carcinoma. Conclusion: Mediastinal tumors have low incidence rate and rich histological types, and their imaging manifestations are diverse. Preoperative differential diagnosis can be made according to their specific imaging characteristics.

Metastases to the parotid glands: An institutional experience.

Metastatic lesions to the salivary gland are rare and mostly affect the parotids. Metastases represent 8% of all malignant lesions of the parotid gland. Around 80% originate from squamous cell carcinomas (SCC) of the head and neck region. Fine needle aspiration (FNA) plays a crucial role in distinguishing primary salivary gland lesions from metastases. Herein we describe our series of metastases to the parotid glands. We analysed 630 parotid gland FNAs over a decade including conventional and liquid-based cytology specimens. Ancillary techniques such as immunocytochemistry (ICC) were conducted on cell blocks. Eighty (12.4%) cases were malignant lesions, of which 53 (63.75%) were metastases including 24% melanoma, 22.6% SCC, 19% renal carcinomas, 7.5% breast carcinomas, 11.3% lung, 9% intestinal and 1.8% testicular, malignant solitary fibrous tumour and Merkel cell carcinoma. The 53 cases, classified according to the Milan system for salivary cytopathology, belonged to 5 Suspicious for malignancy (SFM) and 48 malignant (M) categories. Forty had a known history of primary malignancy (75.4%), while 13 were suspicious to be a metastatic localisation (24.5%), distributed as 5SFM (2SCC and 3Melanoma) and 8 M. A combination of clinical history, cytomorphology and ICC identified 100% of them. Fine needle aspiration plays a central role in the diagnostic workup of patients with metastatic lesions to their parotid glands, thereby defining the correct management. Diagnostic accuracy may be enhanced by applying ICC. Although melanoma and SCC are the most common histological types, several other malignancies may also metastasize to the parotid glands and should be kept into consideration.

Solitary Fibrous Tumor of Mediastinum-A Rare Clinical Entity and Review of Literature

Solitary fibrous tumour is an uncommon mesenchymal tumour with indolent clinical behaviour as compared to its malignant counterpart. There are very few case reports of extra-pleural malignant SFT arising from the mediastinum.We hereby present a rare case report of solitary fibrous tumor arising from mediastinum and reviewing the literature of this entity.

Solitary fibrous tumor of the prostate: Case report and review of the literature

Solitary Fibrous Tumor (SFT), typically found in the pleura, is exceptionally rare in the prostate. We present the case of a 54-year-old man with prostatic SFT, initially revealed as an abdominopelvic mass. Subsequent investigations shown a vascular tumor. The pathological examination found a 23 cm tumor originating from the prostate, composed of short spindle-shaped and polygonal cells with mild nuclear atypia. Occasional mitoses were observed, with vascular invasion. Immunohistochemically, the tumor cells strongly expressed CD34 and STAT6. The maximum Ki-67 labeling index for the tumor cells was 4%. This case report has highlighted one of the rare occurrences of solitary fibrous tumor. A comprehensive microscopic examination paired with an immunohistochemical analysis will be necessary to establish an accurate diagnosis.

68Ga-Fibroblast Activation Protein Inhibitor PET/CT Improves Detection of Intermediate and Low-Grade Sarcomas and Identifies Candidates for Radiopharmaceutical Therapy.

Fibroblast activation protein-α (FAP) is often highly expressed by sarcoma cells and by sarcoma-associated fibroblasts in the tumor microenvironment. This makes it a promising target for imaging and therapy. The level of FAP expression and the diagnostic value of 68Ga-FAP inhibitor (FAPI) PET for sarcoma subtypes are unknown. We assessed the diagnostic performance and accuracy of 68Ga-FAPI PET in various bone and soft-tissue sarcomas. Potential eligibility for FAP-targeted radiopharmaceutical therapy (FAP-RPT) was evaluated. Methods: This prospective observational trial enrolled 200 patients with bone and soft-tissue sarcoma who underwent 68Ga-FAPI PET/CT and 18F-FDG PET/CT (186/200, or 93%) for staging or restaging. The number of lesions detected and the uptake (SUVmax) of the primary tumor, lymph nodes, and visceral and bone metastases were analyzed. The Wilcoxon test was used for semiquantitative assessment. The association of 68Ga-FAPI uptake intensity, histopathologic grade, and FAP expression in sarcoma biopsy samples was analyzed using Spearman r correlation. The impact of 68Ga-FAPI PET on clinical management was investigated using questionnaires before and after PET/CT. Eligibility for FAP-RPT was defined by an SUVmax greater than 10 for all tumor regions. Results: 68Ga-FAPI uptake was heterogeneous among sarcoma subtypes. The 3 sarcoma entities with the highest uptake (mean SUVmax ± SD) were solitary fibrous tumor (24.7 ± 11.9), undifferentiated pleomorphic sarcoma (18.8 ± 13.1), and leiomyosarcoma (15.2 ± 10.2). Uptake of 68Ga-FAPI versus 18F-FDG was significantly higher in low-grade sarcomas (10.4 ± 8.5 vs. 7.0 ± 4.5, P = 0.01) and in potentially malignant intermediate or unpredictable sarcomas without a World Health Organization grade (not applicable [NA]; 22.3 ± 12.5 vs. 8.5 ± 10.0, P = 0.0004), including solitary fibrous tumor. The accuracy, as well as the detection rates, of 68Ga-FAPI was higher than that of 18F-FDG in low-grade sarcomas (accuracy, 92.2 vs. 80.0) and NA sarcomas (accuracy, 96.9 vs. 81.9). 68Ga-FAPI uptake and the histopathologic FAP expression score (n = 89) were moderately correlated (Spearman r = 0.43, P < 0.0002). Of 138 patients, 62 (45%) with metastatic sarcoma were eligible for FAP-RPT. Conclusion: In patients with low-grade and NA sarcomas, 68Ga-FAPI PET demonstrates uptake, detection rates, and accuracy superior to those of 18F-FDG PET. 68Ga-FAPI PET criteria identified eligibility for FAP-RPT in about half of sarcoma patients.

Solitary Fibrous Tumor of the Prostate: Case Report and Review of the Literature

Solitary fibrous tumor (SFT), typically found in the pleura, is exceptionally rare in the prostate. We present the case of a 54-year-old man with prostatic SFT, initially revealed as an abdominopelvic mass. Subsequent investigations shown a vascular tumor. The pathological examination found a 23-cm tumor originating from the prostate, composed of short spindle-shaped and polygonal cells with mild nuclear atypia. Occasional mitoses were observed, with vascular invasion. Immunohistochemically, the tumor cells strongly expressed CD34 and STAT6. The maximum Ki-67 labeling index for the tumor cells was 4%. This case report has highlighted one of the rare occurrences of solitary fibrous tumor. A comprehensive microscopic examination paired with an immunohistochemical analysis will be necessary to establish an accurate diagnosis.

Renal cell carcinoma, solitary fibrous tumor and papillary thyroid carcinoma: an exceptional association

Renal cell carcinoma, solitary fibrous tumor and papillary thyroid carcinoma: an exceptional association

Preservation of vision through an interdisciplinary approach: a case report of intraorbital malignant solitary fibrous tumor

Preservation of vision through an interdisciplinary approach: a case report of intraorbital malignant solitary fibrous tumor