A case of uncontrollable hemorrhage caused by laparoscopic biopsy for large solitary fibrous tumor in the pelvis

Abstract

Solitary fibrous tumor (SFT) is a mesenchymal fibroblastic tumor that occurs anywhere in the body. It is often difficult to make a definite diagnosis of abdominopelvic tumors by imaging alone. Pathological information obtained by biopsy is useful. Here, the authors report a case with a large SFT of the mesometrium, in which a laparoscopic biopsy caused uncontrolled hemorrhage. A 70-year-old woman with a large solitary fibrous tumor (SFT) of the mesometrium underwent a laparoscopic biopsy that caused uncontrollable hemorrhage. Pelvic magnetic resonance imaging revealed hyper-vascular tumor with 102-mm diameter adjacent to the uterus. Because laparoscopic biopsy for pathological diagnosis caused uncontrollable hemorrhage, the authors performed laparotomy, hysterectomy, bilateral salpingo-oophorectomy, and ureterovesiconeostomy due to bladder injury. The tumor was completely resected. SFT was diagnosed by histological immunostaining. Furthermore, there was no regional recurrence within 24 months of the surgery. As SFT is hyper-vascular tumor, laparoscopic biopsy should be performed with careful preparation of countermeasures for hemorrhage.