Matsuishi Kozue, Eto Kojiro, Morito Atsushi, Hamasaki Hirokazu, Morita Keisuke, Ikeshima Satoshi, Horino Kei, Shimada Shinya, Baba Hideo
Department of Surgery, Japan Community Health Care Organization Kumamoto General Hospital, 10-10 Toricho, Yatsushiro, Kumamoto, 866-8660, Japan.
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Surg Case Rep. 2021 May 22;7(1):127. doi: 10.1186/s40792-021-01209-4.
Solitary fibrous tumor (SFT) is a relatively rare mesenchymal tumor that mainly affects adults. Its prognosis is good after curative resection, but distant recurrences after 10 years or longer have been reported. Recurrent SFT usually arises as a local lesion; distant metastasis is rarely reported. Here, we report lung metastases that recurred a decade after excising a retroperitoneal primary SFT.
A 44-year-old woman had an SFT resected from her right retroperitoneum at our hospital. Ten years later, at age 54, she underwent a lung resection after CT showed three suspected metastases in her left lung. All three were histologically diagnosed as lung metastases from the retroperitoneal SFT. However, whereas the primary SFT had 1-2 mitotic cells/10 high power fields (HPF), the metastatic lesion increased malignancy, at 50/10 HPF.
Patients who have had resected SFTs should be carefully followed up, as malignancy may change in distant metastasis, as in this case.
孤立性纤维性肿瘤（SFT）是一种相对罕见的间叶性肿瘤，主要发生于成年人。根治性切除术后预后良好，但有报道称10年或更长时间后会出现远处复发。复发性SFT通常表现为局部病变；远处转移很少见。在此，我们报告1例在切除腹膜后原发性SFT十年后出现肺转移的病例。
一名44岁女性在我院接受了右腹膜后SFT切除术。十年后，54岁时，CT显示左肺有3处疑似转移灶，随后她接受了肺切除术。所有3处病灶经组织学诊断均为腹膜后SFT的肺转移。然而，原发性SFT每10个高倍视野（HPF）有1-2个有丝分裂细胞，而转移灶的恶性程度增加，每10个HPF有50个。
如本病例所示，已切除SFT的患者应仔细随访，因为远处转移时恶性程度可能发生变化。
