Solitary Fibrous Tumor of the Female Genital Tract A Case Report and Review of the Literature

Abstract

Originally thought to be limited to mesothelial-lined surfaces, solitary fibrous tumor (SFT) has now been reported in numerous extrathoracic sites. The female genital tract is among the rarest reported sites involving SFT, and only a handful of cases have been described. Although features pointing to a more malignant biological behavior have been described, these tumors remain unpredictable in their clinical course. We present a case of primary SFT originating in the vulva of a 45-year-old woman, only the fourth such case and only the ninth case of primary SFT of the female genital tract. The tumor presented as a 60-mm, well-circumscribed, painless lump and comprised bland spindle cells in a collagenized stroma with hypercellular and hypocellular foci. Immunohistochemically, the spindle cells were strongly positive for CD34, Bcl 2, and vimentin, with focal positivity for CD99. Immunohistochemical staining for MNF116, desmin, smooth muscle actin, ER, PR, and S100 was negative. There has been no recurrence after 6 months. We discuss the principal differential diagnoses of spindle cell mesenchymal tumors of the vulva and review the previously published cases of primary SFTs originating in the female genital tract. We also stress the importance of informing clinicians involved in these cases of the potential for an unpredictable clinical outcome.

Solitary Fibrous Tumor of the Uterus Presenting With Lung Metastases

“…The female genital tract is one of the rarest primary sites for SFT (12). Excluding the present case, we are aware of only 3 cases of uterine SFT reported in the literature (8)(9)(10), and this is the first documented case of a uterine SFT presenting with metastasis.…”

Lipomatous angiomyofibroblastoma: A 20-year literature review

“…Vaginal SFT presents in peri-menopausal women as a painless lump composed of bland spindle cells in a collagenized stroma with hypercellular and hypocellular foci. Immunohistochemically, unlike LAMF, spindle cells in SFT are reactive for Bcl 2, CD34 and are partially reactive for CD99 [14].…”

“…Extra-thoracic solitary fibrous tumors (SFT) are uncommon [14,15]. Clinically and morphologically, vaginal SFT mimics LAMF and should be considered in the differential diagnosis.…”

Tumor fibroso solitario de la pleura

“…El tumor fibroso solitario se ha informado en múltiples localizaciones de la economía corporal [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] . Estas lesiones tienen las mismas características citogenéticas, morfológicas e inmunohistoquímicas de las observadas en esta neoplasia en la pleura, por lo cual se ha establecido que se trata de la misma lesión 7 .…”

“…Se he reportado en membranas serosas como el peritoneo 40 , ya sea parietal, visceral, retroperitoneo, mesenterio, omento, pared abdominal y sacos herniarios 41 ; también se ha informado en el pericardio, en el cual existen a la fecha 5 casos reportados 42,43 . Otras localizaciones incluyen: meninges, con aproximadamente 30 casos reportados 44 ; cordón espinal, con 12 casos; cavidad oral, con 50 casos 45 ; glándula mamaria, con 50 casos 46 ; tracto gastrointestinal, en el cual se debe hacer su distinción con el tumor estromal gastrointestinal, mediante inmunohistoquímica 47 ; piel, con 10 casos reportados 48 ; riñón, con 20 casos reportados 49 ; tracto genital femenino 50 , y otras 32 localizaciones como órbi-ta, cavidad nasal 51 , espacio pélvico, hígado 52 , mediastino, próstata, glándulas salivales 53 , vías respiratorias superiores, páncreas 54 , corazón, conjuntiva, tiroides 55 , vejiga, amígdalas, vaina carotídea, testículo, entre otros.…”