An abdominal-sacral approach with preoperative embolisation for vulvar solitary fibrous tumour: a case report

Abstract

Background Solitary fibrous tumours (SFTs) in the female genital tract are uncommon. Resection of these tumours is controversial because it can cause life-threatening haemorrhage. We report a case of vulvar SFT that was excised in a combined abdominal-sacral approach after preoperative embolisation. Case presentation At another hospital, an inoperable intrapelvic tumour was diagnosed in a 34-year-old woman. Computed tomography and magnetic resonance imaging showed that the uterus, urinary bladder and rectum were compressed laterally by a pelvic tumour with a maximum diameter of 11 cm. This mass was hypervascular and had a well-defined border. Transperineal biopsy was performed, and immunostaining revealed that the mass was an SFT. The tumour was supplied by feeding vessels from the right iliac arteries. First, we embolised the feeding vessels. Second, we performed surgical resection in a combined abdominal-sacral approach; no blood transfusion was necessary, and no perioperative complications occurred. The final pathological diagnosis was SFT that was positive for CD34 and signal transducer and activator of transcription 6 according to immunohistochemical staining. Conclusion During a year of follow-up, the disease did not recur. Treatment of pelvic SFT should aim at complete resection through various approaches after careful measures are taken to prevent haemorrhage.

Successful Surgical Treatment of a Recurrent Pelvic Solitary Fibrous Tumor of Uterine Origin Accompanied by Doege-Potter Syndrome: A Case Report

“…However, repeated surgeries for recurrent SFTs or too-large tumors can cause distressful adhesion, and complete surgical resection is considerably challenging [ 15 ]. To avoid a positive surgical margin and reduce operative blood loss, several studies have reported the utility of preoperative transcatheter arterial embolization, as SFTs are usually hypervascular tumors [ 5 , 25 ]. In our case, the main pelvic tumor had grown so large that the tumor had severe adhesion to the rectum and the left ureter, so it might have been wise to consider preoperative transcatheter arterial embolization followed by surgery.…”