Type:
Educational Exhibit
Keywords:
Neoplasia, Multidisciplinary cancer care, Diagnostic procedure, MR, CT, Oncology, Musculoskeletal soft tissue
Authors:
N. Gennaro, A. Marrari, O. G. Santonocito, S. Imparato, L. Balzarini; Rozzano/IT
DOI:
10.26044/ecr2019/C-3447
Background
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms commonly arising from the pleura and the peritoneum.
Most of them are benign,
but 10-20% are malignant.
SFTs are defined malignant when histopathological analysis shows at least one among high mitotic activity,
high cellularity,
necrosis,
hemorrhage or pleomorphism.
Typical radiological,
clinical and laboratory characteristics include:
- pleural or peritoneal localization
- round shape and well-defined margins
- increased contrast enhancement
- inhomogeneous enhancement directly proportional to the size of lesions (due to central necrosis,
hemorrhage and cystic changes with a patchy pattern)
- branching vascular pattern
- middle-aged adults with no sex predilection
- nonspecific signs and symptoms,
mainly related to the tumor's mass effect (dysphagia,
bowel/respiratory obstruction),
hemorrhage (epistaxis) or IGF production (Doege-Potter syndrome)
- clubbing and hypertrophic pulmonary osteoarthropathy (HPO)
- CD34+,
CD117-,
vimentine+
Very few reports have been published about rare tumor localizations with consequent atypical clinical presentations.
These include pelvis,
abdomen,
retroperitoneum,
buccal space,
maxillary sinuses,
visceral organs and extremities [1].
We identified in our Institute selected cases of atypical extrathoracic SFTs which underwent multimodality imaging (US/CT/MRI/PET).