A giant breast malignant solitary fibrous tumor: A rare case report and brief review

Abstract

Solitary fibrous tumors (SFTs), which were first identified in the pleura and later at multiple anatomical locations, are rare mesenchymal neoplasms. The characteristics of SFTs include well-circumscribed margins, intense vascularity and a relatively indolent clinical course. SFTs originating from the breast are rare. To the best of our knowledge, only 33 cases of breast SFTs, including five malignant tumors, have been reported to date. In the present study, a rare case of complete resection of a giant malignant SFT is reported. A 48-year-old female patient who visited Weifang People's Hospital (Weifang, China) had a 2-year history of a right palpable breast lesion. The patient reported no other symptoms, such as skin changes or nipple discharge. An ultrasound examination revealed a giant, well-circumscribed, heterogeneous and hypoechoic lesion with central and peripheral blood flow. Owing to the large size of the lesion, mammography and magnetic resonance imaging were not feasible. Core needle biology showed that the lesion was a malignant spindle cell tumor. Following this, mastectomy and sentinel lymph node biopsy were performed. The sentinel lymph nodes exhibited metastasis. A definitive diagnosis of malignant SFT was made by microscopic examination with immunohistochemistry. The treatment strategy for benign breast SFTs should be complete surgical excision, whereas for malignant SFTs, it should include radical resection along with radiotherapy and chemotherapy. Owing to the indolent nature and late recurrence and metastasis of malignant breast SFTs, regular patient follow-up for a longer duration is essential.

A giant solitary fibrous tumor of the abdominal pelvic cavity: A case report and literature review

“…[10] SFT was characterized by the presence of a mucus-like interstitial matrix with alternating sparse and abundant cellular areas, coarse collagen fibers, and a branching hemangioepithelioma-like vascular pattern. [15] Numerous studies [16][17][18][19] have shown that nuclear atypia, high mitotic count (>4/10 HPF), tumor size >10 cm, tumor sites, positive margins and necrosis, or hemorrhagic are the most reliable indicators of poor prognosis. The latest immunohistochemical study showed that CD34, CD99, Bcl-2, and STAT-6 were previously thought to be the most useful positive immunohistochemical markers for SFT, with a high degree of specificity and sensitivity.…”

Solitary Fibrous Tumor of the Breast: A Rare Case and its Diagnostic Pitfalls

“…Historically, SFTs are sub-classified into three groups: i) Benign (local disease); ii) not otherwise specified (usually not metastatic); and iii) malignant. 4 The general criteria adopted for malignant SFTs include a large tumor size, mitotic rate of ≥4/10 highpower fields (HPFs), nuclear pleomorphism, and necrosis. Demicco et al proposed a modified fourvariable risk stratification model for development of metastasis in solitary fibrous tumors based on age, tumor size, necrosis and mitotic count into three risk classes of low, intermediate, and high risk.…”