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腹壁孤立性纤维瘤复发表现为单侧胸腔积液和肿块:1例病例报告并文献复习

Solitary fibrous tumor of the abdominal wall re-surfacing as unilateral pleural effusion and mass: A case report and review of the literature.

作者信息

Bi Xia, Zhai Jixian, Chun Carrie D

机构信息

Internal Medicine, Scripps Green Hospital, 10666 N. Torrey Pines Road, La Jolla, CA 92037, USA.

Department of Biology, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China.

出版信息

Respir Med Case Rep. 2017 Oct 31;23:4-7. doi: 10.1016/j.rmcr.2017.10.013. eCollection 2018.

Abstract

BACKGROUND

Solitary fibrous tumors (SFTs) are rare fibroblastic mesenchymal neoplasms that were initially described in the pleura, but have been increasingly recognized to occur in other parts of the body. They have been traditionally regarded as indolent tumors that are rare to metastasize after surgical resection. Here, we describe a case of a Filipino female who initially presented with unilateral pleural effusion and mass, and was ultimately diagnosed with recurrent solitary fibrous tumor that originated from the abdominal wall. Then, we reviewed existing literature on intra- and extrathoracic SFTs with focus on pathological characteristics, recommendations for treatment as well as post-treatment surveillance.

CASE PRESENTATION

A 79-year-old Filipino female with a history of solitary fibrous tumor of the abdominal wall status post complete surgical resection 3 years ago presented with unilateral pleural effusion and mass, and was diagnosed with recurrent solitary fibrous tumor that metastasized to the lung. She was not a candidate for systemic chemotherapy and ultimately died 1 year later from progressive respiratory failure.

CONCLUSIONS

Solitary fibrous tumor are rare mesenchymal tumors that were initially described in the pleura, but have now been reported in many other sites. Complete surgical resection is the mainstay therapy for all cases; however, long-term monitoring and surveillance several years after initial presentation is crucial to prevent disease recurrence, and adjuvant treatment may be necessary for patients with high-risk features. Additional studies are needed to demonstrate the clinical utility of risk stratification models and to develop post-treatment surveillance guidelines for extrathoracic SFTs.

摘要

背景

孤立性纤维性肿瘤(SFTs)是一种罕见的成纤维细胞性间叶组织肿瘤,最初在胸膜中被描述,但现在越来越多地被发现在身体的其他部位。它们传统上被认为是惰性肿瘤,手术切除后很少发生转移。在此,我们描述了一例菲律宾女性病例,该患者最初表现为单侧胸腔积液和肿块,最终被诊断为起源于腹壁的复发性孤立性纤维性肿瘤。然后,我们回顾了关于胸内和胸外SFTs的现有文献,重点关注病理特征、治疗建议以及治疗后的监测。

病例介绍

一名79岁的菲律宾女性,有3年前腹壁孤立性纤维性肿瘤完全手术切除史,现出现单侧胸腔积液和肿块,被诊断为转移至肺部的复发性孤立性纤维性肿瘤。她不适合进行全身化疗,最终1年后死于进行性呼吸衰竭。

结论

孤立性纤维性肿瘤是罕见的间叶组织肿瘤,最初在胸膜中被描述,但现在已在许多其他部位被报道。完整的手术切除是所有病例的主要治疗方法;然而,初次就诊后数年的长期监测对于预防疾病复发至关重要,对于具有高危特征的患者可能需要辅助治疗。需要更多研究来证明风险分层模型的临床实用性,并制定胸外SFTs的治疗后监测指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/149a/5683803/09c3a50b192c/gr1.jpg

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