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Giant solitary fibrous tumor of the pleura with high-grade sarcomatous overgrowth accompanied by lipid-rich, rhabdomyosarcomatous, and pleomorphic components: A case report.

Abstract Solitary fibrous tumors are mesenchymal tumors presenting as fibroblastic neoplasms with prominent branching vascular patterns, which are often generated from the pleura. Most solitary fibrous tumors are benign; however, some can turn malignant. High-grade sarcomas from solitary fibrous tumors include multidirectional histopathological components.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390282
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 50
DP  - 2017 Dec
TI  - Giant solitary fibrous tumor of the pleura with high-grade sarcomatous overgrowth
      accompanied by lipid-rich, rhabdomyosarcomatous, and pleomorphic components: A
      case report.
PG  - e8926
LID - 10.1097/MD.0000000000008926 [doi]
AB  - RATIONALE: Solitary fibrous tumors are mesenchymal tumors presenting as
      fibroblastic neoplasms with prominent branching vascular patterns, which are
      often generated from the pleura. Most solitary fibrous tumors are benign;
      however, some can turn malignant. High-grade sarcomas from solitary fibrous
      tumors include multidirectional histopathological components. PATIENT CONCERNS:
      We describe our experience of a giant high-grade sarcoma with mixed components
      generated from a solitary fibrous tumor of the pleura in a 67-year-old female
      patient presenting with cough and left-sided chest pain. The patient had been
      diagnosed with a pleural mass in the left chest by X-ray about 30 years earlier. 
      However, the tumor was allowed to grow, without surgical intervention, for a long
      time. INTERVENTIONS: Thoracic surgeons performed the removal of the giant pleural
      tumor; the tumor measured 18.0 x 14.5 x 10 cm in size, and was considered a giant
      tumor generated from the pleura of the left chest cavity. DIAGNOSES: The
      surgically removed tumor was solid and light brownish, and included myxoid and
      arabesque pattern lesions. The tumor also showed hemorrhagic and necrotic
      lesions. Moreover, spindle cells with less atypia, resembling fibroblasts, were
      noted. These spindle tumor cells were CD34- and Stat6-positive, suggesting a
      solitary fibrous tumor. Some of the spindle tumor cells were surrounded by thick 
      collagenous fibers. Considering that the tumor originated from the parietal
      pleura, the tumor was defined as a solitary fibrous tumor in origin. The tumor
      also comprised high-grade sarcomatous components; these included lipid-rich,
      rhabdomyosarcomatous, and pleomorphic components. The high-grade sarcoma
      component included bizarre tumor cells with severe atypia. OUTCOMES: Tumor
      recurrence occurred in the left chest about 4 months after the surgery, and the
      patient died 8 months postoperatively. LESSONS: The present case clearly
      demonstrates that a solitary fibrous tumor can develop into high-grade
      sarcomatous overgrowth, including lipid-rich, rhabdomyosarcoma, and pleomorphic
      sarcoma components, if left untreated for a prolonged period. This case provides 
      profound insights about the natural history, histogenesis, differentiation, and
      malignant transformation of solitary fibrous tumors.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Nakaya, Takeo
AU  - Nakaya T
AD  - Department of Pathologyy.
FAU - Oshiro, Hisashi
AU  - Oshiro H
AD  - Department of Pathologyy.
FAU - Takigami, Ayako
AU  - Takigami A
AD  - Department of Pulmonary Medicine.
FAU - Kanai, Yoshihiko
AU  - Kanai Y
AD  - Department of Thoracic Surgery.
FAU - Tetsuka, Kenji
AU  - Tetsuka K
AD  - Department of Thoracic Surgery.
FAU - Hagiwara, Koichi
AU  - Hagiwara K
AD  - Department of Pulmonary Medicine.
FAU - Fujii, Hirofumi
AU  - Fujii H
AD  - Department of Oncology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
FAU - Endo, Shunsuke
AU  - Endo S
AD  - Department of Thoracic Surgery.
FAU - Tanaka, Akira
AU  - Tanaka A
AD  - Department of Pathologyy.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Fatal Outcome
MH  - Female
MH  - Humans
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local
MH  - Pleural Neoplasms/*pathology/surgery
MH  - Rhabdomyosarcoma/*pathology/surgery
MH  - Sarcoma/*pathology/surgery
MH  - Solitary Fibrous Tumor, Pleural/*pathology/surgery
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000008926 [doi]
AID - 00005792-201712150-00032 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(50):e8926. doi: 10.1097/MD.0000000000008926.