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前列腺孤立性纤维瘤:病例报告及文献复习。

Solitary Fibrous Tumor of the Prostate: A Case Report and Literature Review.

机构信息

Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan.

Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu 5011194, Japan.

出版信息

Medicina (Kaunas). 2021 Oct 23;57(11):1152. doi: 10.3390/medicina57111152.

Abstract

Solitary fibrous tumors (SFTs) usually occur in the pleura and account for two-thirds of all cases; however, SFTs occurring in the prostate are extremely rare. Approximately 25 cases have been reported in the literature to date. This study reports the case of a 43-year-old man referred to our hospital with the chief complaint of a pelvic tumor after careful examination. The tumor marker levels were within normal limits. T2-weighted magnetic resonance imaging revealed a tumor, demonstrating primarily low signal intensity. It showed a capsule-like rim at the left lobe of the prostate, suggesting that the tumor was partially invading the rectal wall. Histopathological examination of needle-core biopsies showed spindle cell neoplasm with small and fusiform cells, strongly expressing signal transducer and activator of transcription 6 (STAT6) with a ramifying vascular network. Therefore, the clinical diagnosis of the patient was SFT of the prostate and robot-assisted radical prostatectomy was performed. Histopathological examination revealed that the tumor was composed of spindle cells with patternless and staghorn patterns. Immunohistochemical analysis showed a strong expression of STAT6. Furthermore, the tumor was partially positive for CD34. Therefore, the patient was diagnosed with SFT of the prostate. Two years after the initial diagnosis, the patient was alive with normal erectile function, continence status, and no evidence of the disease.

摘要

孤立性纤维瘤(SFT)通常发生在胸膜,占所有病例的三分之二;然而,发生在前列腺的 SFT 极为罕见。迄今为止,文献中已报道了约 25 例。本研究报告了 1 例 43 岁男性患者的病例,该患者因仔细检查后出现骨盆肿瘤而被转诊至我院。肿瘤标志物水平在正常范围内。T2 加权磁共振成像显示肿瘤,主要表现为低信号强度。肿瘤位于前列腺左叶,呈包膜样边缘,提示肿瘤部分侵犯直肠壁。针芯活检的组织病理学检查显示梭形细胞肿瘤,有小而梭形细胞,强烈表达信号转导和转录激活因子 6(STAT6),伴有分支状血管网络。因此,患者的临床诊断为前列腺 SFT,并进行了机器人辅助根治性前列腺切除术。组织病理学检查显示肿瘤由梭形细胞组成,呈无模式和鹿角状模式。免疫组织化学分析显示 STAT6 强表达。此外,肿瘤部分 CD34 阳性。因此,患者被诊断为前列腺 SFT。初始诊断后 2 年,患者存活,勃起功能正常,控尿状况良好,无疾病证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b8c/8621876/058bb226df1e/medicina-57-01152-g001.jpg

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