Yi Bing, Bewtra Chandra, Yussef K, Silva Edibaldo
Department of Surgery, Creighton University Medical Center, Omaha, Nebraska 68131, USA.
Am Surg. 2007 May;73(5):478-80.
We are reporting a giant pelvic neoplasm, a rare solitary fibrous tumor that presented with a large bowel obstruction and bilateral ureteral obstruction because of its size and location. Preoperative diagnosis required complex pathological studies to exclude a high-grade sarcoma suspected clinically. Complete resection was required for resolution of obstructive symptoms. Prognosis for solitary fibrous tumors is usually good after complete resection. Recurrence and metastasis may be related to rare aggressive histological features, including nuclear atypia, hypercellularity, greater than four mitoses/10 high power fields, and necrosis. Because histology is not always a reliable predictor of prognosis, careful long-term follow-up is necessary for this tumor. Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms most likely arising from mesenchymal cells. SFTs were originally described in the pleura, the most common site for this tumor; however, extrathoracic SFTs are seemingly diagnosed with increased frequency. We report a case of a giant pelvic SFT that required complicated clinical management.
我们报告了一例巨大盆腔肿瘤，这是一种罕见的孤立性纤维瘤，因其大小和位置导致大肠梗阻和双侧输尿管梗阻。术前诊断需要进行复杂的病理研究，以排除临床怀疑的高级别肉瘤。为缓解梗阻症状，需要进行完整切除。孤立性纤维瘤完整切除后的预后通常良好。复发和转移可能与罕见的侵袭性组织学特征有关，包括核异型性、细胞增多、每10个高倍视野有超过4个有丝分裂象以及坏死。由于组织学并不总是预后的可靠预测指标，因此对该肿瘤进行仔细的长期随访是必要的。孤立性纤维瘤（SFTs）是罕见的梭形细胞肿瘤，最有可能起源于间充质细胞。SFTs最初在胸膜中被描述，这是该肿瘤最常见的部位；然而，胸外SFTs的诊断频率似乎有所增加。我们报告了一例需要复杂临床处理的巨大盆腔SFT病例。
