Bongiovanni M, Viberti L, Giraudo G, Morino M, Papotti M
Department of Pathology, University of Turin, Torino, Italy.
Virchows Arch. 2000 Oct;437(4):445-9. doi: 10.1007/s004280000268.
Solitary fibrous tumour (SFT), first described as a pleural lesion, has been reported in several extrathoracic sites over the past 10 years. We describe a SFT of the left adrenal gland incidentally discovered in a 23-year-old, 22-week pregnant woman and characterised by a rapid growth during the third trimester of pregnancy. Elevated serum and urinary levels of cortisol and elevated blood levels of delta 4 androstendione and 17-OH progesterone were observed. After spontaneous delivery, the patient underwent laparoscopic resectioning of the mass and of the left adrenal gland from which the tumour was apparently originating. The kidney was not involved, and no other abdominal tumours were found. Histological and immunohistochemical features were typical of SFT of pleura and other locations. Only one case of adrenal SFT is on record, and the adrenal gland is to be added to the long list of extrathoracic locations of SFT. The association with pregnancy was a previously unrecognised event in SFT. The focal expression of progesterone receptors in the tumour cells may be related to pregnancy. This observation prompted an analysis of steroid hormone receptors in SFT of classical sites (pleura). Two of five cases had focal progesterone receptors too, a finding which deserves further investigations in a much larger series of SFTs.
孤立性纤维瘤（SFT）最初被描述为一种胸膜病变，在过去10年中已报道见于多个胸外部位。我们描述了一例在一名23岁、孕22周的孕妇中偶然发现的左肾上腺SFT，其特点是在妊娠晚期迅速生长。观察到血清和尿皮质醇水平升高，以及δ4雄烯二酮和17-羟孕酮的血水平升高。自然分娩后，患者接受了腹腔镜下对肿块及明显起源肿瘤的左肾上腺的切除术。肾脏未受累，未发现其他腹部肿瘤。组织学和免疫组化特征为胸膜及其他部位SFT的典型表现。有记录的肾上腺SFT病例仅1例，肾上腺应被添加到SFT胸外部位的长长的列表中。与妊娠的关联在SFT中是一个此前未被认识到的情况。肿瘤细胞中孕激素受体的局灶性表达可能与妊娠有关。这一观察结果促使对经典部位（胸膜）的SFT中的类固醇激素受体进行分析。5例中有2例也有局灶性孕激素受体，这一发现值得在更大系列的SFT中进一步研究。
