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一名同时患有肺腺癌患者的单发孤立性纤维瘤脑转移:病例报告及文献复习

Single Solitary Fibrous Tumor Brain Metastasis in a Patient with Simultaneous Adenocarcinoma of the Lung: Case Report and Review of the Literature.

作者信息

Kaya Erin A, Carlson Jonathan D, Thomas Cheddhi J, Wagner Aaron E, Fairbanks Robert K, Lamoreaux Wayne T, Lee Christopher M

机构信息

Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA.

Washington State University (WSU) Elson S. Floyd College of Medicine (ESFCOM), Spokane, WA, USA.

出版信息

Case Rep Med. 2020 Apr 7;2020:3938270. doi: 10.1155/2020/3938270. eCollection 2020.

Abstract

We present a unique case of a patient simultaneously diagnosed with solitary fibrous tumor (SFT) and unrelated adenocarcinoma of the lung, both proven with separate pathology. It was subsequently found that the SFT had metastasized to the brain by additional pathology, and not the predicted adenocarcinoma. SFTs are a rare mesenchymal neoplasm that accounts for less than 2% of all reported soft tissue tumors. SFTs most commonly arise in the thoracic cavity, but are frequently found in various locations throughout the body, and rarely metastasize to the brain. This case highlights that rare neoplasms, such as SFT, should not be ruled out as a potential cause of metastasis. Due to the rarity of this clinical situation, we also provide a review and discussion of previously reported SFT cases and the use of postoperative radiation therapy. The optimal treatment for individual patients remains unclear in this unique situation. Surgical resection followed by adjuvant Gamma Knife radiation therapy to the surgical bed appears to be a safe option for local treatment of SFT in select patients. Further studies are needed of this rare clinical situation in order to better understand and optimize future treatments for patients with SFT and metastasis to the brain.

摘要

我们报告了一例独特的病例,该患者同时被诊断出患有孤立性纤维瘤(SFT)和与之无关的肺腺癌,二者均经独立的病理学检查证实。随后经进一步病理学检查发现,发生脑转移的是SFT,而非预期的腺癌。SFT是一种罕见的间叶性肿瘤,占所有已报告软组织肿瘤的比例不到2%。SFT最常发生于胸腔,但也常见于全身各处,很少转移至脑。该病例表明,不应排除SFT等罕见肿瘤作为转移潜在病因的可能性。鉴于这种临床情况的罕见性,我们还对先前报告的SFT病例以及术后放射治疗的应用进行了综述和讨论。在这种独特情况下,针对个体患者的最佳治疗方案仍不明确。对于部分患者,手术切除后对手术床进行辅助伽玛刀放射治疗似乎是局部治疗SFT的一种安全选择。需要对这种罕见的临床情况进行进一步研究,以便更好地理解并优化未来对SFT及脑转移患者的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc4/7166291/2fe619143e19/CRIM2020-3938270.001.jpg

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