Hatayama Rei, Rino Yasushi, Kure Yoshio, Komori Keisuke, Kanetsuna Yukiko, Suganuma Nobuyasu, Yamada Roppei
Department of Gastrointestinal Surgery, International University of Health and Welfare School of Medicine Atami Hospital, Atami, Shizuoka, Japan.
Department of Surgery, Yokohama City University, Yokohama, Kanagawa, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.25-0193. Epub 2025 Aug 7.
Solitary fibrous tumor (SFT) is a mesenchymal tumor and accounts for less than 2% of all soft tissue tumors. It is most commonly found in the pleura and has a relatively good prognosis.
A 53-year-old woman was diagnosed with thyroid cancer and underwent a plain CT scan for preoperative examination. A mass measuring 23 mm in maximum diameter was incidentally found near the greater curvature of the stomach. Although its continuity with the stomach was unclear, an additional 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT scan revealed abnormal accumulation of Sstandardized uptake value (SUV) of max 4.2 at the same site. Percutaneous biopsy and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) were anatomically difficult, so a laparoscopic resection was performed as a diagnostic treatment. The specimen measured 28 mm in maximum diameter and was elastically hard. There was a proliferation of small- to medium-sized spindle cells, and no atypical cells were observed. No tumor components were found at the resection margin. The diagnosis of SFT was therefore made. The patient was discharged 2 days after surgery. Although it would have been difficult to diagnose the tumor based on preoperative imaging alone, we were able to perform minimally invasive tumor removal by laparoscopic surgery and make a diagnosis.
Although the prognosis of SFT is generally good, its treatment has not been established. In particular, SFT originating from the greater omentum is extremely rare. We report this case along with some relevant literature.
孤立性纤维性肿瘤(SFT)是一种间叶组织肿瘤,占所有软组织肿瘤的比例不到2%。它最常见于胸膜,预后相对较好。
一名53岁女性被诊断为甲状腺癌,术前行普通CT扫描检查。偶然在胃大弯附近发现一个最大直径为23毫米的肿块。尽管其与胃的连续性尚不清楚,但进一步的18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)/CT扫描显示同一部位标准化摄取值(SUV)最大为4.2的异常摄取。经皮活检和超声内镜引导下细针穿刺抽吸(EUS-FNA)在解剖学上操作困难,因此进行了腹腔镜切除术作为诊断性治疗。标本最大直径为28毫米,质地硬且有弹性。可见中小梭形细胞增生,未观察到非典型细胞。切缘未发现肿瘤成分。因此诊断为SFT。患者术后2天出院。虽然仅根据术前影像学很难诊断该肿瘤,但我们能够通过腹腔镜手术进行微创肿瘤切除并做出诊断。
虽然SFT的预后通常良好,但其治疗方法尚未确立。特别是起源于大网膜的SFT极为罕见。我们报告此病例并结合一些相关文献。