Solitary fibrous tumor of the ischioanal fossa—a multidisciplinary approach to management with radiologic-pathologic correlation

Bhat, Ambarish P.; Layfield, Lester J.; Tewari, Sanjit O; Gaballah, Ayman H.; Davis, Ryan M.; Wu, Zhiqiang

doi:10.1016/j.radcr.2018.01.030

Cited by 16 publications

(7 citation statements)

References 24 publications

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“…In our review, only 2 out of the 13 cases (including ours) had a preoperative biopsy. From these 2 cases, Bhat et al report that a CT-guided biopsy was performed; however, it was complicated with intralesional hemorrhage [ 16 ]. In the report by Morikawa et al, an ultrasound-guided biopsy was performed to assist with the management strategy, as the patient was reluctant to have an operation in case of a benign lesion.…”

Section: Discussionmentioning

confidence: 99%

Perianal Solitary Fibrous Tumor in a Rare Anatomical Presentation: A Case Report and Literature Review

et al. 2021

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Patient: Male, 78-year-old Final Diagnosis: Solitary fibrous tumor Symptoms: Growth Medication:— Clinical Procedure: Excision biopsy Specialty: Pathology • Surgery Objective: Rare disease Background: Solitary fibrous tumors (SFTs) account for <2% of all soft tissue tumors and are slow-growing neoplasms of mesenchymal origin, which have been reported in various locations. They are frequently observed at the pleura and a perianal location is extremely rare. They show no predisposition by sex, are mainly benign, and usually occur between the 5 th and 7 th decades of life. Case Report: We report the case of an 80-year-old man with no comorbidities except hypertension, who presented with an asymptomatic perineal mass. Magnetic resonance imaging showed a solid tumor measuring 3.5×2.5 cm identified in the perineal midline. It was very close to the anal sphincter, showing no extension to the rectum or anus. The tumor was completely excised with negative margins. The postoperative course was uneventful and he was discharged home, free of any symptoms. The pathological examination showed a benign completely excised SFT, and no further treatment was necessary. At the 6-month and 1-year follow-ups, there was no sign of recurrence. Conclusions: A comprehensive review of all the reported cases of perianal SFTs shows that the majority of these tumors present with no symptoms and have a favorable prognosis. Diagnosis is possible only after a pathological examination. The criterion standard of treatment is complete excision with negative margins. Once excised, the tumors have low rates of recurrence and metastasis. Tumors very close to the anal sphincter and with malignant potential need to be operated on with extra care to obtain clear margins without disrupting the continence mechanism.

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Section: Discussionmentioning

confidence: 99%

Perianal Solitary Fibrous Tumor in a Rare Anatomical Presentation: A Case Report and Literature Review

et al. 2021

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“…[3,[6][7][8] e probability of malignancy within a SPN may be estimated using existing models. [9][10][11][12][13][14] Guidelines from the American College of Chest Physicians [1,15,16] recommend direct surgical approach or follow-up with serial CT scans, depending on the high or low malignant probability of the SPN, respectively. [9,17] However, in cases of a SPN with intermediate probability of malignancy or for patients with a high surgical risk, the recommendation is to biopsy the lesion, most often CT-guided.…”

Section: Introductionmentioning

confidence: 99%

Role of Computed Tomography-guided Biopsies in the Era of Electromagnetic Navigational Bronchoscopy: A Retrospective Study of Factors Predicting Diagnostic Yield in Electromagnetic Navigational Bronchoscopy and Computed Tomography Biopsies

Atkins

Marjara

Kaifi

et al. 2020

JCIS

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Objectives: Over 25% of the high-risk population screened for lung cancer have an abnormal computed tomography (CT) scan. Conventionally, these lesions have been biopsied with CT guidance with a high diagnostic yield. Electromagnetic navigational bronchoscopy (ENB) with transbronchial biopsy has emerged as a technology that improves the diagnostic sensitivity of conventional bronchoscopic biopsy. It has been used to biopsy lung lesions, due to the low risk of pneumothorax. It is, however, a new technology that is expensive and its role in the diagnosis of the solitary pulmonary nodule (SPN) is yet to be determined. The purpose of this study was to evaluate the diagnostic yield of CT-guided biopsy (CTB) following non-diagnostic ENB biopsy and identify characteristics of the lesion that predicts a low diagnostic yield with ENB, to ensure appropriate use of ENB in the evaluation of SPN. Materials and Methods: One hundred and thirty-five lung lesions were biopsied with ENB from January 2017 to August 2019. Biopsies were considered diagnostic if pathology confirmed malignancy or inflammation in the appropriate clinical and imaging setting. We evaluated lesions for several characteristics including size, lobe, and central/peripheral distribution. The diagnostic yield of CTB in patients who failed ENB biopsies was also evaluated. Logistic regression was used to identify factors likely to predict a non-diagnostic ENB biopsy. Result: Overall, ENB biopsies were performed in 135 patients with solitary lung lesions. ENB biopsies were diagnostic in 52% (70/135) of the patients. In 23 patients with solitary lung lesions, CTBs were performed following a non-diagnostic ENB biopsy. The CTBs were diagnostic in 87% of the patients (20/23). ENB biopsies of lesions <21.5 mm were non-diagnostic in 71% of cases (42/59); 14 of these patients with non-diagnostic ENB biopsies had CTBs, and 86% of them were diagnostic (12/14). ENB biopsies of lesions in the lower lobes were non- diagnostic in 59% of cases (35/59); 12 of these patients with non-diagnostic ENB biopsies had CTBs, and 83% were diagnostic (10/12). ENB biopsies of lesions in the outer 2/3 were non-diagnostic in 57% of cases (50/87); 21 of these patients with non-diagnostic ENB biopsies had CTBs, and 86% were diagnostic (18/21). Conclusion: CTBs have a high diagnostic yield even following non-diagnostic ENB biopsies. Lesions <21.5 mm, in the outer 2/3 of the lung, and in the lower lung have the lowest likelihood of a diagnostic yield with ENB biopsies. Although CTBs have a slightly higher pneumothorax rate, these lesions would be more successfully diagnosed with CTB as opposed to ENB biopsy, in the process expediting the diagnosis and saving valuable medical resources.

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“…Among the mortality of tumor-related diseases, the HCC mortality of males ranks second, and the HCC mortality of females ranks sixth ( 2 ). The pathological grading of HCC is an important predictor of the recurrence and survival of HCC patients after surgery or liver transplantation ( 6 , 7 ). The risk of recurrence and metastasis of patients with poorly-differentiated HCC is significantly higher than that of patients with moderately-differentiated HCC ( 14 , 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that the incidence of HCC is affected by many risk factors ( 5 , 6 ). HCC mostly occurs on the basis of liver cirrhosis, and then undergoes several stages of transformation, from regenerative nodules to dysplasia to liver cancer, which is accompanied by tumor angioarchitecture and blood perfusion ( 7 , 8 ). Early detection and diagnosis of HCC lesions and recurrence are important for improving the long-term prognosis and quality of life of patients.…”

Section: Introductionmentioning

confidence: 99%

Application of contrast-enhanced ultrasound in the pathological grading and prognosis prediction of hepatocellular carcinoma

Xuan¹,

Wu²,

Li³

et al. 2021

Transl Cancer Res TCR

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Background: To explore the clinical application value of contrast-enhanced ultrasound (CEUS) in the pathological grading and prognosis prediction of hepatocellular carcinoma (HCC).Methods: A retrospective analysis was performed of 128 patients with primary HCC who underwent CEUS examination in our hospital from January 2017 to June 2020. Patients were divided into three groups: highly-differentiated group, moderately-differentiated group, and poorly-differentiated group. Quantitative analysis of the relationships between the rise time (RT), time to peak (TTP), mean transit time (mTT), intensity maximum (Imax), enhancement rate, and pathological grade of CEUS was performed. In addition, the follow-up patients were divided into a recurrence group and non-recurrence group, and the relationships between RT, TTP, mTT, Imax, and enhancement rate of CEUS were analyzed.Results: Among the 128 patients, 23 were highly-differentiated, 63 were moderately-differentiated, and 42 were poorly-differentiated. In addition, there were 31 patients in the recurrence group and 97 patients in the non-recurrence group. RT, TTP, and enhancement rate had significant differences in the highlydifferentiated, moderately-differentiated, and poorly-differentiated groups. At the same time, RT and TTP were positively correlated with the differentiation degree, while the enhancement rate was negatively correlated with the differentiation degree. Furthermore, RT, TTP, and enhancement rate were statistically significant for the diagnosis of HCC with high, moderate, and poor differentiation, among which RT had the highest diagnostic accuracy. In the recurrence group, RT, TTP, and Imax were lower than those in the nonrecurrence group, and the enhancement rate was greater than that in the non-recurrence group. Moreover, low levels of RT, TTP, and Imax along with positive microvascular invasion (MVI) and poor differentiation were risk factors for HCC recurrence, and there was no significant relationship between the average tumor diameter and HCC recurrence.Conclusions: CEUS can significantly show the differences between the RT, TTP, and enhancement rate of HCC across different levels of differentiation. It can also predict whether the disease will relapse.Moreover, low levels of RT, TTP, and Imax as well as positive MVI and poor differentiation can cause the recurrence of HCC.

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Solitary fibrous tumor of the ischioanal fossa—a multidisciplinary approach to management with radiologic-pathologic correlation

Cited by 16 publications

References 24 publications

Perianal Solitary Fibrous Tumor in a Rare Anatomical Presentation: A Case Report and Literature Review

Perianal Solitary Fibrous Tumor in a Rare Anatomical Presentation: A Case Report and Literature Review

Role of Computed Tomography-guided Biopsies in the Era of Electromagnetic Navigational Bronchoscopy: A Retrospective Study of Factors Predicting Diagnostic Yield in Electromagnetic Navigational Bronchoscopy and Computed Tomography Biopsies

Application of contrast-enhanced ultrasound in the pathological grading and prognosis prediction of hepatocellular carcinoma

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