Takahashi Akimasa, Nishimura Hiroki, Amano Tsukuru, Deguchi Mari, Yoshino Fumi, Kasei Ryo, Kimura Fuminori, Moritani Suzuko, Murakami Takashi
Department of Obstetrics and Gynecology, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Kusatsu, Japan.
World J Surg Oncol. 2021 Mar 29;19(1):92. doi: 10.1186/s12957-021-02206-5.
Solitary fibrous tumours (SFTs) in the female genital tract are uncommon. Resection of these tumours is controversial because it can cause life-threatening haemorrhage. We report a case of vulvar SFT that was excised in a combined abdominal-sacral approach after preoperative embolisation.
At another hospital, an inoperable intrapelvic tumour was diagnosed in a 34-year-old woman. Computed tomography and magnetic resonance imaging showed that the uterus, urinary bladder and rectum were compressed laterally by a pelvic tumour with a maximum diameter of 11 cm. This mass was hypervascular and had a well-defined border. Transperineal biopsy was performed, and immunostaining revealed that the mass was an SFT. The tumour was supplied by feeding vessels from the right iliac arteries. First, we embolised the feeding vessels. Second, we performed surgical resection in a combined abdominal-sacral approach; no blood transfusion was necessary, and no perioperative complications occurred. The final pathological diagnosis was SFT that was positive for CD34 and signal transducer and activator of transcription 6 according to immunohistochemical staining.
During a year of follow-up, the disease did not recur. Treatment of pelvic SFT should aim at complete resection through various approaches after careful measures are taken to prevent haemorrhage.
女性生殖道孤立性纤维瘤（SFTs）并不常见。这些肿瘤的切除存在争议，因为它可能导致危及生命的出血。我们报告一例经术前栓塞后采用腹部 - 骶骨联合入路切除的外阴SFT病例。
在另一家医院，一名34岁女性被诊断出盆腔内有无法手术切除的肿瘤。计算机断层扫描和磁共振成像显示，子宫、膀胱和直肠被一个最大直径为11 cm的盆腔肿瘤侧向压迫。该肿块血管丰富，边界清晰。进行了经会阴活检，免疫染色显示该肿块为SFT。肿瘤由右侧髂动脉的供血血管供血。首先，我们栓塞了供血血管。其次，我们采用腹部 - 骶骨联合入路进行手术切除；无需输血，且未发生围手术期并发症。最终病理诊断为SFT，免疫组化染色显示CD34和信号转导及转录激活因子6呈阳性。
在一年的随访中，疾病未复发。盆腔SFT的治疗应在采取仔细措施预防出血后，通过各种方法旨在实现完全切除。
