College of Osteopathic Medicine-Pomona, Western University of Health Sciences, Pomona, CA, USA.
Department of Internal Medicine, Community Memorial Hospital, Ventura, CA, USA.
Am J Case Rep. 2022 May 31;23:e935445. doi: 10.12659/AJCR.935445.
BACKGROUND Solitary fibrous tumor (SFT) of the pleura is a rare fibroblastic neoplasm. It is commonly found incidentally on imaging and is usually benign but has significant potential to recur as a malignant tumor. Patients present asymptomatically or with pulmonary symptoms such as cough or shortness of breath. Cardiac invasion of an SFT can create an avenue for peripheral tumor embolization and critical limb ischemia, as in this case report. There is no prior published report of recurring malignant SFT presenting as critical limb ischemia. CASE REPORT We report a rare presentation of malignant SFT recurrence in a 57-year-old woman with critical limb ischemia of both lower extremities secondary to bilateral tumor emboli. The patient's primary tumor was treated with surgical resection alone. Upon recurrence, the tumor growth was so extensive that it was no longer amenable to surgical resection at the time of her critical limb ischemia. The patient presented with bilateral numbness and tingling, without any pulmonary symptoms. CONCLUSIONS Although it is sporadic, clinicians should know that an aggressive malignant SFT can embolize and present as critical limb ischemia. The possibility of tumor emboli provides a pressing reason to surgically resect SFT masses in their early stages before any cardiac invasion.
胸膜孤立性纤维瘤（SFT）是一种罕见的成纤维细胞肿瘤。它通常在影像学检查中偶然发现，通常为良性，但有很大的复发为恶性肿瘤的潜力。患者表现为无症状或有肺部症状，如咳嗽或呼吸急促。SFT 的心脏侵犯可导致外周肿瘤栓塞和肢体重要缺血，正如本病例报告所示。目前尚无先前发表的复发性恶性 SFT 表现为肢体重要缺血的报告。病例报告：我们报告了一例罕见的恶性 SFT 复发病例，一名 57 岁女性因双侧肿瘤栓子导致双下肢肢体重要缺血。患者的原发性肿瘤仅接受了手术切除。复发时，肿瘤生长如此广泛，以至于在她发生肢体重要缺血时已经不再适合手术切除。患者表现为双侧麻木和刺痛，没有任何肺部症状。结论：尽管罕见，但临床医生应该知道，侵袭性恶性 SFT 可发生肿瘤栓子并导致肢体重要缺血。肿瘤栓子的可能性提供了一个紧迫的理由，即在任何心脏侵犯之前，尽早手术切除 SFT 肿块。
