Abstract: Objective To investigate the clinical features of solitary fibrous tumor (SFT) in the thorax and its optimal surgical approaches. Methods We retrospectively reviewed the clinical records of 16 patients with SFT in the thorax in our hospital between January 2004 and June 2010. There were 8 males and 8 females, with a median age of 49 years (1973 years). Laboratory examination showed normal results. Chest Xray and computed tomographic scan revealed lung tumor in 8 cases, mediastinal mass in 3 cases, fibrous tumor in 2 cases, pleural mass in 2 cases, and retroperitoneal mass in 1 case. Five patients underwent CT guided biopsy or thoracoscopy, and 3 of them were diagnosed to have SFT. There was no clear diagnosis for the remaining 13 cases before operation. None of them had been exposed to asbestos. Symptoms were present in 5 patients. All patients underwent surgical treatment with resection performed through routine thoracotomy in 10 cases and by means of videoassisted thoracoscopy in 6 cases. The tumors originated from the visceral pleura in 12 patients, from parietal pleura in 3 patients (from diaphragmatic pleura in 1, and costal pleura in 2), and from the lung in 1 patient. Results All tumors were totally excised. Immunohistochemical staining showed CD34 was positive in all tumors. There was no postoperative mortality and no major complications. All patients were regularly rechecked and followed up. The followup was ranged from 1 to 72 months, with a median time of 21 months. During the followup, all patients survived and no recurrence was observed by means of chest X radiography or CT. Conclusion SFT tumors in the thorax are rare neoplasms and can have giant diameters. Wide local excision is recommended as the best therapeutic option. The SFT has the possibility of recurrence, and careful longterm clinical followup is required.
Objective To study the MRI features of intracranial solitary fibrous tumor (ISFT). Methods MRI features of 8 patients with ISFT treated between December 2010 and December 2015 were retrospectively analyzed and relavent literatures about its neuroimaging were reviewed. Results All the 8 cases were single solitary fibrous tumor (SFT), among which 4 arose from and beneath the tentorium, 2 in the left cerebellopontine angle, 1 in jugular foramen region and 1 in saddle area. All tumors had clear boundary, 3 were oval or round, 2 were irregular-shaped, 2 were lobulated and 1 was dumb-bell shaped. Tumor size ranged from 35 to 65 mm. On pre-contrast MRI, 5 cases were mixed with hypo to hyperintense signals on (T1 weighted image) T1WI and heterogeneous on (T2 weighted image) T2WI. The rest 3 cases were featured by solid and cystic components; the solid component was hypo to isotense on T1WI and hypointense on T2WI while the cystic areas, which were not enhanced in the postcontrast images, were hypo and hyperintense on T1WI and T2WI, respectively. All the areas with low T2 signal intensity were strongly enhanced after gadolinium administration. Flow-empty actions, peritumoral edema and “dural tail” sign was found in 6, 3 and 0 cases, respectively. All the 3 cystic cases were confirmed as malignant ISFT while the rest 5 were benign. Conclusions MRI manifestation of ISFT has some characteristics. There may exist some correlations between the intratumoral cyst and malignant potential. However, the diagnosis of ISFT remains dependent on histopathology.
Objective To review the research progress of intraspinal solitary fibrous tumor (SFT). Methods The domestic and foreign researches on intraspinal SFT were extensively reviewed and analyzed from four aspects, including disease origin, pathological and radiological characteristics, diagnosis and differential diagnosis, and treatment and prognosis. Results SFT is an interstitial fibroblastic tumor with a low probability of occurrence in the central nervous system, especially in the spinal canal. In 2016, the World Health Organization (WHO) used the joint diagnostic term “SFT/hemangiopericytoma” according to the pathological characteristics of mesenchymal fibroblasts, which can be divided into three levels according to specific characteristics. The diagnosis process of intraspinal SFT is complex and tedious. It has relatively variable imaging manifestations and specific pathological changes of NAB2-STAT6 fusion gene, which often requires differential diagnosis with neurinoma, meningioma, etc. The treatment of SFT is mainly resection, which can be assisted by radiotherapy to improve the prognosis. Conclusion Intraspinal SFT is a rare disease. Surgery is still the main treatment. It is recommended to combine preoperative or postoperative radiotherapy. The efficacy of chemotherapy is still unclear. In the future, more studies are expected to establish a systematic diagnosis and treatment strategy for intraspinal SFT.