Pata Francesco, Orsini Vincenzo, Lucisano Ada Maria, Pafundi Donato Paolo, Sacco Rosario
Department of General Surgery, Magna Graecia University of Catanzaro, Germaneto, 88100 Catanzaro, Italy.
Ann Ital Chir. 2010 Nov-Dec;81(6):457-60.
A rare case of Solitary fibrous tumor (SFT) of the pelvis is reported. A 76-years-old man presented with a low abdominal pain, acute urine retention and constipation. Imaging studies (US, CT MR) showed an 17 x 10 x 9 ovoid mass in the pelvis, dislocating bladder and rectum. Finally, trans-rectal needle biopsy suggested the diagnosis of SFT. En bloc excision of tumor and rectum (because of strong adhesions) was performed. Histological examination showed spindle and fibroblastic-like cells dispersed in collagenous areas with positive stains for CD34, bcl-2, CD99 and it confirmed diagnosis of SFT. No postoperative complications occurred, only vesico-sphincter dyssynergia was found by urodynamics. After 5 years, patient is disease-free. SFT is, usually, benign tumor with slow growth and excellent prognosis. Complete surgical resection is the only curative treatment. However, 10-15% of SFT are malignant and histological findings cannot always predict clinical behaviour. For this reason, careful and long term follow-up is necessary after surgery.
本文报道了一例罕见的盆腔孤立性纤维瘤(SFT)病例。一名76岁男性患者出现下腹部疼痛、急性尿潴留和便秘。影像学检查(超声、CT、磁共振成像)显示盆腔内有一个17×10×9厘米的椭圆形肿块,使膀胱和直肠移位。最终,经直肠穿刺活检提示为SFT。由于粘连严重,对肿瘤和直肠进行了整块切除。组织学检查显示梭形和成纤维细胞样细胞散在于胶原区域,CD34、bcl-2、CD99染色呈阳性,确诊为SFT。术后未发生并发症,尿动力学检查仅发现膀胱括约肌协同失调。5年后,患者无病生存。SFT通常是一种生长缓慢、预后良好的良性肿瘤。完整的手术切除是唯一的治愈性治疗方法。然而,10% - 15%的SFT是恶性的,组织学表现并不总能预测临床行为。因此,术后需要进行仔细且长期的随访。