Radiologic and Pathologic Findings of a Huge Solitary Fibrous Tumor of the Liver with Malignant Transformation: A Case Report (original) (raw)
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Malignant Solitary Fibrous Tumor of the Liver: AIRP Best Cases in Radiologic-Pathologic Correlation
RadioGraphics, 2017
A 68-year-old woman with a large mass in the liver was referred to our hospital. The mass was detected with ultrasonography (US) during follow-up of an invasive no-special-type breast carcinoma (grade 2, stage T1cN0M0R0) that expressed progesterone and estrogen receptors, which had been diagnosed 6 months earlier. The patient had no symptoms related to the mass or relevant history (eg, viral hepatitis or alcohol abuse). Laboratory test results did not reveal abnormalities, and α-fetoprotein test results were negative. Imaging Findings Abdominal computed tomography (CT) demonstrated a wellcircumscribed tumor located in the right liver lobe, with lobulated borders and a compressive effect on adjacent organs. The tumor measured 13.3 × 11.6 × 13.5 cm (longitudinal × anteroposterior × transverse) and was hypoattenuating at nonenhanced CT, without calcifications or macroscopic fat. After contrast material administration, CT showed arterial supply via a tortuous hepatic artery (Fig 1a) and progressive heterogeneous enhancement in delayed phases, without washout or necrosis (Fig 1b). The tumor exhibited a pseudocapsule (Fig 1b). No other lesions were seen, and the remaining liver had no alterations. There were no signs of invasion of adjacent structures or dilatation of the bile ducts. Editor's Note.-RadioGraphics continues to publish radiologic-pathologic case material selected from the American Institute for Radiologic Pathology (AIRP) "best case" presentations. The AIRP conducts a 4-week Radiologic Pathology Correlation Course, which is offered five times per year. On the penultimate day of the course, the best case presentation is held at the American Film Institute Silver Theater and Cultural Center in Silver Spring, Md. The AIRP faculty identifies the best cases, from each organ system, brought by the resident attendees. One or more of the best cases from each of the five courses are then solicited for publication in RadioGraphics. These cases emphasize the importance of radiologic-pathologic correlation in the imaging evaluation and diagnosis of diseases encountered at the institute and its predecessor, the Armed Forces Institute of Pathology (AFIP).
2017
Background: Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal tumor. It can originate from abdominal soft tissue which is extremely scarce, and liver indeed is super scant site. SFT liver (SFTL) is mostly benign, but it can be malignant and aggressive with metastases and a potential of recurrence. Hypoglycemia is the least reported feature which is resistant to medical management and will be resolved following resection of a SFT of liver. Case Report: A 67-year-old man presented with episodes of sudden onset loss of consciousness since 3 months before first visit. He was a previously healthy farmer, without any other complaint or past medical history except for episodes of sever hypoglycemia. Laboratory testing revealed hypoglycemia which was temporarily response to glucose infusion, hypoglycemia was refractive, and whole physical examination and laboratory tests were done and there were no abnormal findings. With probability of finding something such as insulinoma or ...
A Giant Solitary Fibrous Tumor of the Liver with Metastasis and Local Recurrence
Journal of Pharmaceutical Research International, 2020
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
Solitary Fibrous Tumor of the Liver : A Case Report
2001
Hepatic solitary fibrous tumor (SFT) is a rare tumor originating from the mesenchyme. Here we report a new case of SFT in the liver and review the clinical presentation, radiological and operative findings, diagnosis, treatment, and outcome. The patient was a 59-year-old man who presented with progressive fatigue for 3 months and an abdominal mass for 3 days. On laboratory tests, no abnormality was detected except that abdominal ultrasonography revealed a 9.0 × 6.2 cm hypoechogenic mass in the left lobe of the liver. A computed tomographic scan confirmed a hypodense lesion in the left lobe of the liver. The patient underwent left hepatectomy. SFT was diagnosed on the basis of histopathological findings. The patient was free from all symptoms and had no signs of local recurrence after 24 months' follow up.
Giant solitary fibrous tumour of the liver
World journal of surgical oncology, 2006
Solitary fibrous tumour (SFT) is an uncommon mesenchymal neoplasm that most frequently affects the pleura, although it has been reported with increasing frequency in various other sites such as in the peritoneum, pericardium and in non-serosal sites such as lung parenchyma, upper respiratory tract, orbit, thyroid, parotid gland, or thymus. Liver parenchyma is rarely affected. Clinically, SFTs cause symptoms after having reached a certain size or when vital structures are involved. In recent years, SFTs are more often identified and distinguished from other tumours with a similar appearance due to the availability of characteristic immunohistochemical markers. In this manuscript we report the case of a large tumour of the liver, which was histologically diagnosed as a SFT, and showed involvement of a single hepatic segment. Because of the patient's presentation and clinical course, it may represent a radiation-induced lesion. When a SFT has been diagnosed, surgery is the treatmen...
Hypoglycemia in a patient with a huge malignant solitary fibrous tumor of the pleura
Pathology International, 2007
Solitary fibrous tumor of the pleura (SFTP) is rare. A 73-yearold man, without past history of diabetes mellitus, was admitted to hospital with profound hypoglycemia, loss of consciousness and respiratory failure. CT indicated a huge heterogenous mass lesion (12 ¥ 12 ¥ 17 cm) at the right thoracic cavity with total atelectasis of the right lower lung. He underwent a standard thoracotomy with complete excision of the tumor. Pathology indicated malignant SFTP with insulin-like growth factor-binding protein-2 production. There were no further incidences of hypoglycemia or respiratory failure after excision of the tumor. Hypoglycemia resulting from a solitary fibrous tumor is uncommon. Standard thoracotomy and complete resection of this giant tumor provided a good result for the present patient.
Non-Islet Cell Tumor Hypoglycemia Caused by Recurrent Pelvic Solitary Fibrous Tumor
Cureus, 2021
Non-islet cell tumor hypoglycemia is a rare paraneoplastic condition caused by an extra-pancreatic tumor. We report a rare case of hypoglycemia caused by a relapsing pelvic solitary fibrous tumor associated with Big-IGF-2 production. A 72-year-old woman was admitted to our hospital because of loss of consciousness and hypoglycemia. She had a history of ovarian solitary fibrous tumor, which has relapsed. From investigation, serum levels of insulin and C-peptide were suppressed; IGF-1 was slightly reduced and IGF-2 was within the normal range, but the IGF-2: IGF-1 ratio was elevated, indicating the presence of Big-IGF-2 secreting non-islet cell tumor. Contrast-enhanced computed tomography (CT) showed a large pelvic mass. She was then submitted to surgical resection of the mass, which histologically proved to be a solitary fibrous tumor. Three months later, she remains asymptomatic. Non-islet cell tumor hypoglycemia should be considered in the differential diagnosis of patients presenting with tumors and recurrent hypoglycemia.
Hepatic solitary fibrous tumor: Report of a rare case
Indian Journal of Pathology and Microbiology, 2012
Solitary fi brous 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 fi broblast-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 benefi ts of adjuvant radio chemotherapy. Complete surgical resection remains the cornerstone of its treatment.
Case 198: Solitary Fibrous Tumor of the Liver
Radiology, 2013
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