Doege–Potter syndrome (DPS) is a rare paraneoplastic disorder characterised by non-islet cell tumour hypoglycaemia (NICTH), resulting from ectopic secretion of insulin-like growth factor 2 (IGF-II) by solitary fibrous tumours (SFTs). We describe the case of an 85-year-old woman, presenting in October 2024, with a chronic subdural haematoma and profound intraoperative hypoglycaemia. Further investigation revealed a large pleural mass; the pathophysiological findings were consistent with DPS, and histopathology confirmed a malignant SFT. Hypoglycaemia resolved after complete tumour resection. The current case highlights the importance of considering NICTH in older patients with unexplained, treatment-resistant hypoglycaemia, especially when comorbidities (like subdural hematoma) mask the clinical picture. A focused narrative review accompanies this report, providing clinicians with practical insights into the spectrum of clinical presentations, diagnostic work-up, therapeutic modalities, and anaesthetic considerations in DPS. Early recognition is crucial to avoid serious complications. Complete surgical removal remains the cornerstone of effective management, while alternative therapies may be needed in inoperable cases.

This case report describes the perioperative management of a massive solitary fibrous tumour of the pleura in a 77-year-old woman undergoing thoracotomy. The tumour, occupying a substantial portion of the right hemithorax, posed significant challenges regarding airway management, haemodynamic stability, and postoperative recovery. A comprehensive anaesthetic strategy was employed, including advanced monitoring, lung isolation, multimodal analgesia, and preemptive planning for potential complications. Careful intraoperative coordination minimised blood loss and maintained haemodynamic stability, avoiding the need for transfusion. Postoperative analgesia was effectively managed with a thoracic epidural catheter, facilitating early mobilisation and respiratory recovery. The patient experienced a favourable postoperative course and was discharged home on the seventh day. This case underscores the importance of individualised anaesthetic planning and multidisciplinary collaboration when managing large intrathoracic tumours.

This study investigates the clinical characteristics, pathological features, immunohistochemical profiles, and prognostic factors of solitary fibrous tumors (SFTs) to provide insights into their management and prognosis. A retrospective analysis was conducted on 43 cases of SFTs diagnosed at a single center. Patient demographics, tumor characteristics, immunohistochemical (IHC) markers, and outcomes were collected. Among the 43 cases, the majority of tumors were infratentorial (81%), and 60% were classified as WHO Grade 1. IHC analyses revealed high expression rates of STAT6 (62.5%), CD34 (82.5%), and Ki-67 (100%). Ki-67 demonstrated the strongest correlation with tumor grade and risk scores (r = 0.62, p < 0.001; r = 0.68, p < 0.001), indicating its role as a significant prognostic marker. CD34 and STAT6 also showed moderate correlations with tumor aggressiveness. Metastatic presentations were noted in 57.5% of cases. The study highlights the heterogeneity of SFTs and the importance of IHC markers in risk stratification. The findings underscore the utility of IHC markers, particularly Ki-67, STAT6, and CD34, in assessing the aggressiveness and prognosis of SFTs. Future studies should focus on multicenter validations, integration of advanced molecular diagnostics, and long-term follow-up to refine risk models and therapeutic strategies.

Recent advances in molecular pathology have transformed the diagnostic landscape and management of human cancer. Increasingly, integration of genomic and epigenomic data with conventional histopathology has improved tumor classification, refined prognostic assessment, and revealed previously unsuspected therapeutic targets. High-throughput techniques such as next-generation sequencing, gene fusion panels, and methylation arrays have expanded applicability to formalin-fixed tissue and enabled simultaneous evaluation of multiple cancer-defining alterations/genetic drivers. In optic nerve gliomas, MAPK pathway activation through BRAF or FGFR1 alterations, or NF1 inactivation, is a basic biological feature with diagnostic implications, while MEK inhibitors may be of clinical benefit in selected patients. Optic nerve sheath/orbital meningiomas demonstrate divergent molecular landscapes depending on location, with NF2-driven and non-NF2-driven pathways informing recurrence risk and behavior. In the orbit, characteristic genetic drivers facilitate diagnosis of mesenchymal tumors such as solitary fibrous tumor (NAB2::STAT6) and alveolar rhabdomyosarcoma (PAX3/7::FOXO1), while molecular profiling assists in distinguishing challenging peripheral nerve and melanocytic lesions. Similarly, lacrimal gland neoplasms parallel salivary gland counterparts, with recurrent fusions such as PLAG1, HMGA2, and MYB::NFIB of great diagnostic utility. These advances underscore the growing role of molecular diagnostics in improving accuracy, guiding prognostication, and refining the classification of rare ocular tumors. As high-throughput techniques continue to mature, integration with evolving spatial and single-cell-based approaches promises to expand our understanding and further personalize diagnostic and therapeutic strategies.

Building a national repository of dural-based lesions: clinical, pathological, and demographic insights from the Indian population.

137P Predicting survival outcomes in solitary fibrous tumours: A retrospective clinicopathological and molecular cohort study

Solitary fibrous tumor of the eyelid: A case report and literature review

260eP Solitary fibrous tumour patterns of presentation and treatment outcomes: Insights from a tertiary care centre

Cavernous Sinus Solitary Fibrous Tumor Resection with EC-IC Bypass via Radial Artery Graft

To study the clinicopathological features, treatment, and prognosis of ocular adnexal sarcomas diagnosed at a tertiary comprehensive hospital in China during 13years. A case series of patients with histopathological diagnoses of ocular adnexal sarcomas at a tertiary general hospital over 13years. Medical records of demographic details, clinicopathological features, treatment, and prognosis at the time of presentation were reviewed. Forty-two cases of ocular adnexal sarcomas were found throughout the study period. The mean age was 37.1years, with 27 males and 15 females. The most common clinical manifestation was exophthalmos (61.9%), and the median time to diagnosis was 6months. These tumors most often occurred in the orbit (83.3%). The most common TNM stage at presentation was T2N0M0 (63.6%). Fifteen different histological types were identified; rhabdomyosarcoma accounted for the highest percentage (21.4%), followed by liposarcoma and malignant solitary fibrous tumor (16.7%). The diagnosis of each subtype depended on histomorphologic characteristics, supplemented by immunohistochemistry and molecular pathology. Most patients (56.8%) underwent multimodality therapy. Thirty-seven (88.1%) patients completed follow-up, while five patients were lost to follow-up. Of these 37 patients, 24 (64.9%) survived and 13 (35.1%) died; 19 (51.4%) experienced local recurrence, and 13 (35.1%) developed metastasis. Ocular adnexal sarcomas are rare and histologically diverse, with rhabdomyosarcoma predominating in children and liposarcoma and malignant solitary fibrous tumor in adults. Middle-aged and elderly patients presenting with unilateral proptosis accompanied by visual impairment, especially in cases of cranio-orbital communication associated with headache, should raise suspicion for the possibility of malignant solitary fibrous tumor to avoid delayed diagnosis. Among liposarcomas, atypical lipomatous tumor/highly differentiated liposarcoma is more common. Accurate pathological diagnosis is crucial and requires a combination of histomorphologic, immunohistochemical, and molecular evaluation.

Solitary fibrous tumor (SFT) is a rare fibroblastic neoplasm that may occur at various anatomic sites, whereas vulvar involvement is exceptional. The myxoid variant of SFT, defined by extensive myxoid stromal change, is exceedingly uncommon and may present diagnostic challenges due to atypical radiologic and histologic features. We report a case of a 35-yr-old woman with a slowly enlarging vulvar mass radiologically interpreted as a benign cystic lesion. Histologic examination revealed a predominantly myxoid spindle cell tumor with staghorn vascular features in its periphery. Immunohistochemistry showed diffuse nuclear STAT6 and CD34 positivity, and molecular analysis confirmed a NAB2:::STAT6 fusion. This case highlights the diagnostic pitfalls associated with myxoid change in vulvar mesenchymal tumors and underscores the importance of immunohistochemical and molecular confirmation.

Solitary fibrous tumor (SFT) is a very uncommon central nervous system (CNS) neoplasm and accounts for less than 1% of primary CNS tumors. After the World Health Organization’s reclassification in 2021, SFT is a rare novel entity. Since SFT is a slow-growing, vascular, and aggressive tumor, it has a likelihood of local recurrence as well as distant metastasis. Surgery remains the main treatment modality, whereas postoperative radiation therapy (PORT) benefits in local control. In this case series, we analyzed the data on intracranial SFT retrospectively among patients who had presented to us in 2024 and underwent surgery in the same year. We reviewed the primary surgery that was done, the extent of resection, clinical presentation, radiological findings, tumor size, post-operative radiotherapy, and a brief follow-up. In this study, 4 cases of intracranial SFT have been discussed along with a review of the literature. Although surgery remains the main treatment domain, PORT is a part of adjuvant treatment in all grades of SFT for controlling local recurrence. Because of the rarity of the disease, most of the previous studies are single-center, and the role of post-operative radiotherapy is in controlling local recurrence; however, conflicting.

Orbital solitary fibrous tumor is extremely rare, and the therapeutic role of radiotherapy remains poorly defined. This study aimed to compare long-term prognosis between surgery plus radiotherapy and surgery alone in complicated orbital solitary fibrous tumor (OSFT), thereby providing evidence-based insights for clinical management. In this retrospective cohort study, we analyzed OSFT patients treated over a decade (January 2013-December 2023). Inclusion criteria encompassed cases with tumor recurrence or histopathological confirmation of anaplastic /malignant variants. By excluding benign cases without recurrence, we could specifically examine the impact of radiotherapy on disease control in complicated OSFTs. Clinico-demographic parameters including age, gender, histopathological subtype, surgical intervention, and radiotherapy administration were collected. Patients were stratified into two treatment arms: surgery alone (n = 19) versus surgery with adjuvant radiotherapy (n = 15). Kaplan-Meier methodology was employed to evaluate recurrence-free survival (RFS) and overall survival (OS), with between-group comparisons using log-rank tests. Cox proportional hazards models were implemented for prognostic factor analysis. From 60 screened OSFT cases, 34 met inclusion criteria: 13 anaplastic, 11 malignant, and 10 recurrent tumors at presentation. The surgery combining radiotherapy cohort demonstrated superior 3-year (88.9% vs. 51.3%) and 5-year RFS (88.9% vs. 44.0%) compared to surgery alone (P = 0.036). A self-controlled analysis of irradiated patients revealed significant post-radiotherapy reduction in recurrence rates (P = 0.025). Univariate Cox analysis identified radiotherapy administration as the sole independent prognostic factor (HR = 0.24). Long-term follow-up demonstrates that adjuvant radiotherapy combined with surgical resection significantly enhanced local control in complicated OSFT, with acceptable radiation-related toxicity profiles.

The solitary fibrous tumor is a rare mesenchymal tumor with predilection for the pleura. Most times it is an incidental diagnosis. Surgery is the recommended treatment. Most solitary fibrous tumors (SFTs) exhibit indolent behavior; however, 10% to 25% may experience recurrence. The aim of this retrospective analysis is to characterize their presentation, therapeutic approach and recurrence and was conducted at the Pulmonary Oncology Department in Unidade Local de Saúde Santa Maria, in Lisbon, Portugal, between May 2013 and December 2023. We identified nine patients, 66,7% male, median age 66 years. The average tumor size was 14.5 cm; 88.9% located in the pleura. Surgical intervention was proposed for eight patients, of whom seven underwent the procedure. Four patients had disease recurrence, three underwent new surgery and one died. One of these three patients underwent post-operative radiotherapy. Again, these three patients suffered a relapse, one underwent surgery and two started systemic therapy. At the time of cut-off, five patients were alive, and four were progression-free. The solitary fibrous tumor is a rare and underdiagnosed entity, which justifies the small number of patients, and its malignant potential is poorly recognized. Our findings are consistent with those reported in the existing literature; however, we observed a higher proportion of tumors exhibiting malignant characteristics. The high prevalence of recurrence is explained by the fact that only complex or previously recurrent cases are referred for discussion at our center.

Introduction: Lung diseases, including lung cancers, are prevalent and deadly worldwide, especially in India. Lung biopsies are crucial for diagnosing pulmonary conditions when non invasive methods are inconclusive. Histopathological examination of biopsy samples provides vital insights for accurate diagnosis and effective treatment planning. Aim: To evaluate the frequency of various histopathological lung lesions detected through biopsy and to assess the demographic and clinical characteristics of patients with lung pathologies. Materials and Methods: This cross-sectional, retrospective study was conducted over a period of 12 months (August 2023 to July 2024) at a tertiary care hospital in Ahmedabad, Gujarat, India. It included 50 patients who underwent lung or pleural biopsies. Patient demographics (age and gender) and clinical features were recorded. The anatomical location (topography) and types of biopsies performed were also evaluated. Histopathological evaluation was done to determine the frequency of neoplastic and non neoplastic lesions. Data were analysed using Microsoft Excel (version 2021). Descriptive statistics and Chi-square tests were applied as appropriate. Results: The cohort consisted of 50 cases who underwent lung biopsy consisted of 32 males and 18 females, with a mean age of 55.18 years. The most common symptoms were cough in 40 (80%), expectoration in 36 (72%) and breathlessness in 30 (60%). A smoking history was noted in 26 (80%) males. Most biopsies were lung-based, predominantly transbronchial in 30 (60%). Histopathologically, 25 (50%) had non neoplastic lesions, including non specific inflammation 16 (64%), granulomatous inflammation indicative of tuberculosis 4 (16%), fungal infection in 2 (8%), reactive mesothelial hyperplasia in 2 (8%), and interstitial fibrosis in 1 (4%). Neoplastic lesions were found in 24 (48%) cases, with Squamous Cell Carcinoma (SCC) being the most frequent in 8 (33%), followed by non small cell lung carcinoma in 5 (21%), adenocarcinoma in 3 (12.5%), small cell carcinoma 3 (12.5%) and solitary fibrous tumour in 1 (4%). Other findings included atypical cells suspicious of malignancy, highgrade bronchial dysplasia, and metastatic carcinoma. Gender differences were statistically significant in both non neoplastic (p-value=0.037) and neoplastic lesions (p-value=0.016). Conclusion: Histopathological examination of lung biopsy specimens plays a crucial role in the accurate diagnosis of various lung diseases, including infections, inflammation, and cancers. Minimally invasive techniques like transbronchial and imaging-guided needle biopsies provide essential tissue samples, enabling early and precise diagnosis. This facilitates tailored treatment plans, ultimately improving patient outcomes and prognosis.

Solitary fibrous tumor (SFT) mimicking an ovarian neoplasm: case report and review of the literature

Emergency interdisciplinary surgeries present major challenges for healthcare teams. We report a case of successful collaboration during emergency resection of a giant solitary fibrous tumor in a 36-year-old woman.Six years after refusing elective surgery for a large right-sided thoracic tumor, the patient presented with dyspnea, facial edema, and signs of venous congestion. Imaging showed a massive tumor displacing the heart and compressing both venae cavae. An open hemiclamshell tumorectomy was performed under veno-arterial ECMO support with a balloon catheter positioned for potential hemostatic control. The surgical intervention was uneventful, and the patient was discharged to rehabilitation 11 days later.This case highlights the importance of structured interdisciplinary collaboration and crisis resource management (CRM) principles in complex, high-risk surgeries. Preoperative joint planning, clear communication, and continuous intraoperative evaluation were the key to achieve a favorable outcome.Interdisciplinary planning and CRM-based communication are essential for the safe and successful management of major emergency surgeries.

Unusual Case of Multiple and Delayed Recurrence of a Solitary Fibrous Tumor of the Pleura After Complete Resection.

According to the 5th edition of the World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS), published in 2021, solitary fibrous tumor (SFT) has been established as a distinct nosological entity within the category of rare mesenchymal neoplasms, exhibiting a propensity for early recurrence and systemic dissemination.The limited prevalence of SFTs accounts for the scarcity of publications describing their specific neuroimaging patterns, while the clinicopathological features of this tumor have been well-characterized. The lack of robust diagnostic criteria poses significant challenges in differentiating SFTs from other intracranial neoplasms, which require fundamentally distinct therapeutic approaches. This report describes the clinical case of a 40-year-old male patient presenting with headache, systemic dizziness, recurrent syncopal episodes, and generalized tonic-clonic seizures over a two-month period. Brain MRI revealed an extra-axial mass in the left parasellar region, attached with its base to the dura mater, accompanied by perifocal edema, mass effect of the left temporal lobe, prominent vascularity, intense homogeneous contrast enhancement, and elevated perfusion values. The preoperative differential diagnosis included meningioma, schwannoma, dural metastatic lesion, chondrosarcoma, and MALT lymphoma. The «YinYang» sign emerged as the most significant diagnostic criterion, characterized by heterogeneous tumor signal intensity on T2- and T2-FLAIR sequences. The patient underwent microsurgical resection of the tumor. Histopathological examination confirmed the diagnosis of SFT. Thus, the use of a comprehensive multiparametric MRI protocol enables a high-probability preoperative suspicion of SFT, which is critical for surgical planning.

Based on current World Health Organization statistics, today there were an estimated 40 million people living with HIV. The specific epidemiological course of HIV infection is represented by a wide range of severe forms of diseases with a predominance of involvement of the central nervous system in the pathological process. Due to the variability of cerebral lesions, there are difficulties in identifying and diagnosing the pathological process, especially when it comes to a tumor process unrelated to HIV infection. A 40-year old man presented with left hemiparesis and headaches. He was diagnosed with human immunodeficiency virus (HIV) in 2020 and does not treat using antiretroviral (ARV) drugs. The CD4 + lymphocyte level was 180 cells/μl. The titers of antibodies to T.gondii were 1:400. Brain magnetic resonance imaging (MRI) revealed an intraaxial mass in the basal ganglia region on the right side, with ring-shaped contrast enhancement, restricted diffusion and extensive perifocal edema, small foci of hemorrhages and vascular shunts, and high perfusion levels. The patient underwent a stereotactic biopsy of the brain mass and postoperative pathological report confirmed the diagnosis of a primary neuroepithelial tumor: Glioblastoma, Not Otherwise Specified (NOS, WHO 2021). Correct and timely detection of the nature of brain lesion is necessary to select the correct treatment strategies and, as a result, reduce mortality. The use of multiparametric MRI protocol recommended to the differential diagnosis of brain lesions in patients with HIV infection.