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大腿部具有中等转移风险的脂肪瘤样孤立性纤维性肿瘤(既往称为血管外皮细胞瘤):一例罕见病例报告并文献复习

Intermediate metastatic risk lipomatous solitary fibrous tumor of the thigh (previously known as hemangiopericytoma): A rare case report with a literature review.

作者信息

Hmaydoosh Ghefar, Ahmad Youssef, Issa Muhsen, Ahmad Ghanem, Knaj Duaa, Ahmad Issa, Issa Rana

机构信息

Faculty of Medicine, Tishreen University, Latakia, Syrian Arab Republic.

Faculty of Medicine, Al Andalus University for Medical Sciences, Tartus, Syrian Arab Republic.

出版信息

Medicine (Baltimore). 2025 Mar 28;104(13):e42052. doi: 10.1097/MD.0000000000042052.

Abstract

RATIONALE

Solitary fibrous tumor (SFT) is a rare mesenchymal tumor, which can arise at any anatomical location and exhibit a wide variety of histopathological characteristics. Lipomatous solitary fibrous tumor (LSFT) is a rare variant of SFT characterized by hemangiopericytoma-like vascular areas with a varying amount of adipocytic tissue. LSFT can be misdiagnosed with other tumors such as liposarcoma which can lead to unnecessary overtreatment for patients.

PATIENT CONCERNS

A 48-year-old man presented to the hospital clinic with a painless swelling located on the medial area of the upper thigh near the femoral artery, he has not seen any change in its size since he has noticed it a year ago.

DIAGNOSES

Histological examination confirmed LSFT with an intermediate risk of metastasis.

INTERVENTIONS

Three-dimensional imaging technology with intravenous injection of contrast material was made and revealed a mass with well-vascularity supplied from the deep femoral artery. The lesion was excised and showed an intramuscular well-circumscribed encapsulated mass.

OUTCOMES

The pathological findings LSFT with intermediate metastatic risk, and he is scheduled to receive radiotherapy for one and a half months. The majority of SFTs display benign histological characteristics and typically follow a slow clinical progression, leading to a favorable prognosis. To date, fewer than 20 cases of malignant LSFT have been documented. In our case, we utilized a recent tumor classification model that evaluates the metastatic potential of SFTs, and long-term follow-up is necessary because there is a chance of aggressive behavior.

LESSONS

LSFTs are usually found incidentally and often present as painless, movable masses. Even though they mostly follow a benign course, long-term follow-up is essential due to the possibility of turning malignant.

摘要

理论依据

孤立性纤维瘤(SFT)是一种罕见的间叶组织肿瘤,可发生于任何解剖部位,并表现出多种组织病理学特征。脂肪瘤样孤立性纤维瘤(LSFT)是SFT的一种罕见变体,其特征是具有类似血管外皮细胞瘤的血管区域以及数量不等的脂肪细胞组织。LSFT可能会被误诊为其他肿瘤,如脂肪肉瘤,这可能导致患者接受不必要的过度治疗。

患者情况

一名48岁男性因大腿上段内侧靠近股动脉处出现无痛性肿块前来医院就诊,自一年前发现该肿块以来,其大小未见任何变化。

诊断

组织学检查确诊为具有中度转移风险的LSFT。

干预措施

进行了静脉注射造影剂的三维成像技术检查,发现一个由股深动脉供血、血供丰富的肿块。切除该病变后,显示为肌肉内边界清晰的包膜肿块。

结果

病理检查结果为具有中度转移风险的LSFT,他计划接受为期一个半月的放疗。大多数SFT表现出良性组织学特征,通常临床进展缓慢,预后良好。迄今为止,记录在案的恶性LSFT病例少于20例。在我们的病例中,我们采用了一种最新的评估SFT转移潜能的肿瘤分类模型,由于存在侵袭性行为的可能性,长期随访是必要的。

经验教训

LSFT通常是偶然发现的,常表现为无痛、可移动的肿块。尽管它们大多病程良性,但由于有可能恶变,长期随访至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/719e/11957647/ae0b2e410226/medi-104-e42052-g001.jpg

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