Solitary Fibrous Tumor of the Pancreas: A Case Report

Abstract

Solitary fibrous tumor (SFT) is an unusual mesenchymal neoplasm that most often arises in the pleura; however, it has recently been described in a number of extrapleural sites. This report describes an extremely rare case of a benign SFT arising in the pancreas. A 41-year-old woman presented in the clinic with right upper abdominal pain. Subsequent ultrasonographic studies revealed a 1.5x1.5x1.4 cm hypoechoic mass within the pancreatic body, which was later confirmed on both helical computerized tomography and magnetic resonance imaging studies. An endocrine tumor was clinically suspected. Laparoscopic enucleation of the mass was performed. Microscopically, the tumor was composed of bland uniform spindle cells arranged between collagen bundles. On immunohistochemical studies, these spindle cells were positive for CD34 and bcl-2 but negative for cytokeratin (AE1+AE3 and Cam5.2), smooth muscle actin, desmin, S-100, and c-kit. Based on the light microscopic morphology and immunohistochemical staining profile, the diagnosis of SFT was rendered.

Solitary fibrous tumour of the pancreas: a case report

“…The tumor cells were positive for CD34 and betacatenin, and negative for c-kit. The diagnosis of SFT relied upon histological features plus immunodetection of CD34 [1][2][3][4][5][6][7][8][9] , and absence of immunoexpression of c-kit. These data ruled out the hypothesis of gastrointestinal stromal tumor [6][7][8] .…”

“…Hypo and hyper cellular areas develop with anarchical arrangement of tumor cells in fascicles; while the fibrocollagen stroma shows variable hyalinization and may present numerous vessels 1,3 . Extra abdominal SFT is reported in the pleura (65%), lung, mediastinum, pericardium, meninges, orbit, oral cavity, salivary glands, nose, paranasal sinus, thyroid, diaphragm, breast, spinal cord, musculoskeletal system, vulva and vagina 5,7 . Intra abdominal STF has been described in the peritoneum, mesentery, adrenals, urogenital tract, stomach, and liver, but pancreatic location is exceeding rare [1][2][3][4][5][6][7][8][9] .…”

“…All tumors had benign histological features. There were four tumor ressections, three pancreatoduodenectomies, and two partial pancreatectomies [1][2][3][4][5][6][7][8][9] . Diagnosis cannot be established exclusively with base on clinical and imaging data, and suggestive histopathology features must be confirmed by immunoistochemical studies.…”

“…Diagnosis cannot be established exclusively with base on clinical and imaging data, and suggestive histopathology features must be confirmed by immunoistochemical studies. SFTs are classically positive for CD34, bcl-2, vimentin and CD99, and negative for cytokeratins, smooth muscle actin, desmin, epithelial membrane antigen, S-100, HMB-45, as well as c-kit 1,3,[5][6][7][8][9] . Case studies can contribute to increase the awareness about this scarcely reported condition.…”

“…2012, Vol. 35, Nº 1, enero-abril intRoDuction Solitary fibrous tumor (SFT) is a very rare neoplasm of mesenchymal origin, characterized by the proliferation of fibroblastlike spindle cells and a variable component of hyalinized collagen [1][2][3][4][5][6][7][8][9] . Hypo and hyper cellular areas develop with anarchical arrangement of tumor cells in fascicles; while the fibrocollagen stroma shows variable hyalinization and may present numerous vessels 1,3 .…”