Zhao Xue-Yan, Zeng Ming, Yang Qiu-Yan, Jing Cai-Ping, Zhang Yu
Department of Pathology Department of CT Division, The People's Hospital of Yan'an, Yan'an Department of Ultrasound, Zichang County Family Planning Service Station, Zichang, China.
Medicine (Baltimore). 2017 Dec;96(48):e8854. doi: 10.1097/MD.0000000000008854.
A solitary fibrous tumor (SFT) is a rare clinical tumor, often manifesting as solitary nodules. It is a rare condition that occurs in the scrotum. Currently, no study has reported this condition.
We reported a case of an SFT in a 77-year-old man, and discuss its diagnosis, differential diagnosis, and treatment. Clinical and histopathological features, as well as the EnVision 2-step method, were used to diagnosis the SFT. The results of imaging tests and surgery indicated that the SFT was located in the right scrotum with 2 connected tumor nodules and a clear perimeter. The larger one was 11.0 cm × 9.3 cm × 8.1 cm, and the smaller one was 3.1 cm × 2.0 cm × 2.0 cm. Pathological results indicated that in both tumor nodules, tumor cells were spindle-shaped with unclear cell boundaries. The nucleus was vacuolated with mild to moderate atypia. In the larger tumor nodule, there were many thin-walled blood vessels with vasodilation or branching. In the smaller tumor nodule, rich blood vessels were found, mostly with fibrous degeneration of the thick walls of blood vessels, and more collagen-like tissue in the interstitial layers. Immunohistochemical results demonstrated diffuse, strongly positive expression of CD34, CD99, Vim, and Bcl-2 markers. The expression of the new fusion gene, NAB2-STAT6, as an alternative tool specifically confirmed the diagnosis of SFT. This patient underwent lump resection without further treatment. The patient is alive after 18-month follow-up.
This case was diagnosed as a SFT according to its histopathological features, immunophenotype. The patient is still alive at 18 months follow-up after the lump resection.
孤立性纤维性肿瘤（SFT）是一种罕见的临床肿瘤，常表现为孤立性结节。发生于阴囊者极为罕见。目前尚无相关研究报道。
我们报告了1例77岁男性的SFT病例，并对其诊断、鉴别诊断及治疗进行讨论。采用临床和组织病理学特征以及EnVision两步法诊断SFT。影像学检查和手术结果表明，SFT位于右侧阴囊，有2个相连的肿瘤结节，边界清晰。较大的结节大小为11.0厘米×9.3厘米×8.1厘米，较小的为3.1厘米×2.0厘米×2.0厘米。病理结果显示，两个肿瘤结节中的肿瘤细胞均为梭形，细胞边界不清。细胞核呈空泡状，有轻度至中度异型性。在较大的肿瘤结节中，有许多薄壁血管，存在血管扩张或分支。在较小的肿瘤结节中，可见丰富的血管，大多血管壁增厚伴有纤维变性，间质层有较多胶原样组织。免疫组化结果显示CD34、CD99、波形蛋白和Bcl-2标记物呈弥漫性、强阳性表达。新融合基因NAB2-STAT6的表达作为一种辅助手段，特异性地确诊了SFT。该患者接受了肿块切除术，未进一步治疗。随访18个月后患者仍存活。
根据其组织病理学特征、免疫表型，该病例被诊断为SFT。肿块切除术后随访18个月，患者仍存活。
