Hashida Sayaka, Yokota Hajime, Oyama Yu, Kawakami Makio, Murakami Satoshi, Kawakami Hiroyuki
Department of Radiation Oncology, Seirei Sakura Citizen Hospital, 2-36-2, Ebaradai, Sakura-city, Chiba 285-8765, Japan.
Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chiba-City, Chiba 260-8677, Japan.
Radiol Case Rep. 2019 Jul 23;14(10):1175-1180. doi: 10.1016/j.radcr.2019.06.030. eCollection 2019 Oct.
We report a case of bulky cardiac metastasis of intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC). A 72-year-old woman developed a chief complaint of chest pain. Contrast-enhanced computed tomography revealed multiple enhanced masses in the heart, retroperitoneum, and femur. Initially, multiple metastases of cardiac primary angiosarcoma were suspected because the cardiac mass was the largest. However, it was diagnosed as SFT/HPC on the basis of biopsy and immunostaining for the retroperitoneal lesion. She had a history of resected brain tumor surgery for a meningioma 11 years earlier, and pathological reconfirmation revealed this was not a meningioma but rather a SFT/HPC. Thus, we found that the enhanced masses were extracranial metastases of an intracranial primary SFT/HPC. She died approximately 3 years after the onset of chest pain. Autopsy confirmed metastasis in the retroperitoneum, liver, lung, mesentery, skeletal muscle, and bone in addition to the heart. SFT/HPC has been reported to easily recur locally and to show systemic metastasis over the long term. Given that SFT/HPC has been recognized as a subtype of meningioma, the differential diagnosis for patients with a history of intracranial tumors, such as meningioma, should include SFT/HPC.
我们报告一例颅内孤立性纤维性肿瘤/血管外皮细胞瘤(SFT/HPC)的巨大心脏转移病例。一名72岁女性因胸痛为主诉就诊。增强计算机断层扫描显示心脏、腹膜后和股骨有多个强化肿块。最初,由于心脏肿块最大,怀疑是心脏原发性血管肉瘤的多发转移。然而,根据对腹膜后病变的活检和免疫染色,诊断为SFT/HPC。她11年前有因脑膜瘤行脑肿瘤切除手术史,病理复查显示这不是脑膜瘤,而是SFT/HPC。因此,我们发现强化肿块是颅内原发性SFT/HPC的颅外转移。她在胸痛发作约3年后死亡。尸检证实除心脏外,腹膜后、肝脏、肺、肠系膜、骨骼肌和骨骼也有转移。据报道,SFT/HPC容易局部复发,并长期出现全身转移。鉴于SFT/HPC已被确认为脑膜瘤的一种亚型,对于有颅内肿瘤病史(如脑膜瘤)的患者,鉴别诊断应包括SFT/HPC。