Solitary fibrous tumor of the ovary

Meena, Manoj; Jindal, Tarun; Duggal, Rajan; Gupta, Atul

doi:10.1111/jog.13627

Cited by 7 publications

(10 citation statements)

References 8 publications

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“…In our series, patients presented over a wide age range, averaging 55 years, similar to previous reports 2,8–23,34–53. Clinical presentation varied by site.…”

Section: Discussionsupporting

confidence: 87%

“…One patient with an ovarian tumor had a mild elevation in serum CA-125, causing concern for an epithelial neoplasm. Previously reported FSFTs had similar presentations,9–22,34–52 with a few exceptions. Tumors of the uterine corpus and cervix occasionally presented with abnormal bleeding 38,50.…”

Section: Discussionmentioning

confidence: 69%

“…The discovery of a recurrent NAB2 - STAT6 gene fusion and STAT6 immunohistochemistry further aided diagnosis of this specific entity 31–33. Despite increased awareness and recognition of SFTs, studies in the female genital tract (FSFTs) are limited to one series of 25 tumors and sporadic case reports, most describing vulvar tumors 9–22,34–53. Our study is the first with a preponderance of nonvulvar tumors.…”

Section: Discussionmentioning

confidence: 93%

“…54,55 FSFTs have been reported most commonly in the vulva, followed by the uterine corpus, and infrequently at other locations. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] In our series, they were seen throughout the gynecologic tract with greater representation in the upper tract than previously reported, particularly within the ovary and fallopian tube/paratubal soft tissue. 22,34,42,44,49,51 Tumors of the upper genital tract were larger than those of the lower tract.…”

Section: Discussionmentioning

confidence: 94%

“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] In our series, they were seen throughout the gynecologic tract with greater representation in the upper tract than previously reported, particularly within the ovary and fallopian tube/paratubal soft tissue. 22,34,42,44,49,51 Tumors of the upper genital tract were larger than those of the lower tract. Although most SFTs are well-circumscribed regardless of location, 4,23 one of our uterine corpus tumors demonstrated infiltrative growth with studding of the periadnexal soft tissue, likely facilitated by its subserosal location, the most common location for uterine corpus tumors in our series and others.…”

Section: Discussionmentioning

confidence: 94%

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Solitary Fibrous Tumors of the Female Genital Tract

Devins

Young

Croce

et al. 2021

American Journal of Surgical Pathology

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We report 27 solitary fibrous tumors of the female genital tract emphasizing nonvulvar locations, variant histology, and prognostic factors. The patients ranged from 25 to 78 years (most were over 40), and tumors occurred in the vulva (7), vagina (2), cervix (2), corpus (6), fallopian tube/paratubal soft tissue (5), and ovary (5). They ranged from 1.5 to 39 (mean = 10.5) cm and were typically solid, but 4 were predominantly cystic. All had a haphazard arrangement of spindled to ovoid cells, with most demonstrating alternating cellular and hypocellular areas and prominent vessels, but 13 lacked hypocellular areas, and 7 had focal diffuse growth with inconspicuous vasculature. Other patterns included corded (8), fascicular (5), trabecular (1), and nested (1). Microcysts (6), myxoid background (8), hyalinization (8), lipomatous differentiation (2), and multinucleated cells (6) were also present, and 10 tumors had necrosis. Vasculature included thin-walled branching "staghorn" (27), thick-walled (7), and hyalinized vessels (5) or dilated anastomosing vascular channels (3). Nuclear atypia ranged from mild (19), moderate (7), to severe (1), and mitoses from 0 to 24/10 HPF (mean = 4). STAT6 was positive in all 25 tumors tested. One tumor showed dedifferentiation; the remainder were classified as benign (19) or malignant (7) based on mitotic rate (univariate stratification model) and as low risk ( 14), intermediate risk (8), or high risk (4) based on the Demicco multivariate risk stratification score. Follow-up (median = 23 mo) was available for 16 patients. Six tumors recurred (2 intermediate risk, 3 high risk, and the dedifferentiated tumor), 5 in the abdomen; the dedifferentiated tumor metastasized to the lung. Multivariate risk stratification was superior to univariate classification, as 5 "benign" tumors were reclassified as intermediate risk using the multivariate model; of these, 2 recurred, and 1 patient died of disease. Upper female genital tract tumors occurred in older patients, were larger, and more frequently classified as high risk compared with those of the lower tract. A trend toward increased cellularity was also seen in the upper tract tumors. Only size (P = 0.04), necrosis (P = 0.04), and Demicco score (P = 0.01) independently correlated with recurrence. Female genital tract solitary fibrous tumors demonstrate a wide range of variant morphologies and occur in diverse sites in addition to the vulva. Tumors were often misdiagnosed as other neoplasms; thus, awareness of solitary fibrous tumors occurring at these sites is crucial in prompting staining for STAT6 to establish this diagnosis. The Demicco risk stratification system effectively predicts behavior.

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“…In our series, patients presented over a wide age range, averaging 55 years, similar to previous reports 2,8–23,34–53. Clinical presentation varied by site.…”

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 69%