Mao Min, Zhou Lei, Huang Chaojun, Yan Xudong, Hu Shuo, Yin Huabin, Zhao Qinghua, Song Dianwen
Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Surg. 2020 Dec 3;7:570582. doi: 10.3389/fsurg.2020.570582. eCollection 2020.
Solitary fibrous tumors are rare neoplasms that originate from mesenchymal tissues and have been found to occur in any site, including the spine and liver. Although most of solitary fibrous tumors have benign features, only 10-20% are malignant and prone to metastasis. No previous reports have described the malignant and metastatic Solitary fibrous tumor arising in both of the liver and thoracic vertebrae. In this article, we present the case of a 60-year-old woman who underwent gross total resection of a meningeal tumor in 2007. She presented 10 years later with a thoracic vertebral mass that caused relentless pain and a lesion in the right lobe of liver. She underwent marginal excision of the T3 tumor with T2-4 pedicular screw fixation in March 2017, then right hemi-hepatectomy was performed to remove the liver lesion in June 2017. Both of the lesions were confirmed to be a metastatic and malignant tumor after surgery. The literature lacks randomized controlled trials and large studies that define the natural history of malignant solitary fibrous tumors and recommendations of precise management plan for the disease. However, the best choice for treatment is gross total resection, which probably provide the optimal treatment to achieve long-term disease-free survival.
孤立性纤维瘤是一种罕见的肿瘤，起源于间叶组织，可发生于任何部位，包括脊柱和肝脏。尽管大多数孤立性纤维瘤具有良性特征，但只有10%-20%为恶性且易于转移。此前尚无关于同时发生在肝脏和胸椎的恶性及转移性孤立性纤维瘤的报道。在本文中，我们报告了一例60岁女性病例，该患者于2007年接受了脑膜瘤全切术。10年后，她出现了一个导致持续性疼痛的胸椎肿块以及肝脏右叶的一个病灶。2017年3月，她接受了T3肿瘤的边缘切除并进行了T2-4椎弓根螺钉固定，随后于2017年6月进行了右半肝切除术以切除肝脏病灶。术后证实这两个病灶均为转移性恶性肿瘤。文献中缺乏定义恶性孤立性纤维瘤自然病史的随机对照试验和大型研究，也缺乏针对该疾病精确管理方案的建议。然而，治疗的最佳选择是全切术，这可能为实现长期无病生存提供最佳治疗。
