Tanaka Moritsugu, Sawai Hirozumi, Okada Yuji, Yamamoto Minoru, Funahashi Hitoshi, Hayakawa Tetsushi, Takeyama Hiromitsu, Manabe Tadao
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Med Sci Monit. 2006 Oct;12(10):CS95-8. Epub 2006 Sep 25.
Solitary fibrous tumor (SFT) is a rare neoplasm frequently involving the pleura. Benign and malignant forms of the tumor occur, the benign variant being three to four times more common than the malignant.
We present herein a rare case of large malignant solitary fibrous tumor (SFT) originating from the peritoneum. An abdominal computed tomography scan revealed a well-defined solid tumor with mixed density. An abdominal ultrasonography (US) revealed a well-circumscribed solid tumor containing a partially cystic lesion. T1-weighted abdominal magnetic resonance imaging demonstrated a hypo- to isointensity, which was a hypo- to hyperintensity on T2-weighted images. Liposarcoma originating from the retroperitoneum was suggested, and the patient underwent a complete resection of the tumor as well as the left kidney because tumor invasion of the upper left kidney was suspected. Immunohistochemically, the spindle-shaped cells were positive for CD34, and the diagnosis was SFT originating from the peritoneum. At the 14-month follow-up evaluation, no recurrence or metastasis was detected.
This case gave us some difficulty, and the correct diagnosis of the peritoneal mass was valuable. To diagnose the malignant potential of this type of tumor accurately may have value to direct the appropriate therapeutic operations after surgery and postoperative progress observation.
孤立性纤维瘤(SFT)是一种罕见的肿瘤,常累及胸膜。该肿瘤有良性和恶性两种形式,良性变体比恶性变体常见三到四倍。
我们在此报告一例罕见的起源于腹膜的大型恶性孤立性纤维瘤(SFT)。腹部计算机断层扫描显示一个边界清晰的混合密度实性肿瘤。腹部超声(US)显示一个边界清晰的实性肿瘤,其中含有部分囊性病变。腹部T1加权磁共振成像显示为低至等信号强度,在T2加权图像上为低至高信号强度。考虑为起源于腹膜后的脂肪肉瘤,由于怀疑肿瘤侵犯左肾上极,患者接受了肿瘤及左肾的完整切除。免疫组织化学检查显示梭形细胞CD34阳性,诊断为起源于腹膜的SFT。在14个月的随访评估中,未发现复发或转移。
该病例给我们带来了一些困难,对腹膜肿块的正确诊断具有重要意义。准确诊断此类肿瘤的恶性潜能对于指导术后适当的治疗操作及术后病情观察可能具有重要价值。