Case Report: A Malignant Liver and Thoracic Solitary Fibrous Tumor: A 10-Year Journey From the Brain to the Liver and the Spine

Abstract

Solitary fibrous tumors are rare neoplasms that originate from mesenchymal tissues and have been found to occur in any site, including the spine and liver. Although most of solitary fibrous tumors have benign features, only 10–20% are malignant and prone to metastasis. No previous reports have described the malignant and metastatic Solitary fibrous tumor arising in both of the liver and thoracic vertebrae. In this article, we present the case of a 60-year-old woman who underwent gross total resection of a meningeal tumor in 2007. She presented 10 years later with a thoracic vertebral mass that caused relentless pain and a lesion in the right lobe of liver. She underwent marginal excision of the T3 tumor with T2-4 pedicular screw fixation in March 2017, then right hemi-hepatectomy was performed to remove the liver lesion in June 2017. Both of the lesions were confirmed to be a metastatic and malignant tumor after surgery. The literature lacks randomized controlled trials and large studies that define the natural history of malignant solitary fibrous tumors and recommendations of precise management plan for the disease. However, the best choice for treatment is gross total resection, which probably provide the optimal treatment to achieve long-term disease-free survival.

Multidisciplinary collaboration for the successful treatment of a giant hepatic solitary fibrous tumor protruding into the thorax: A case report

“…Imaging is often non-specific, meaning that using radiography to distinguish SFTs from other tumors, such as hepatocellular carcinoma, leiomyoma, sarcoma, sclerosed hemangioma and inflammatory pseudotumors, may be challenging ( 22 ). The current diagnosis of SFT is based on the histopathological and immunohistochemical features ( 27 ). Histopathological characteristics of an SFT include spindle cells and collagen fibers ( 27 ).…”

“…The current diagnosis of SFT is based on the histopathological and immunohistochemical features ( 27 ). Histopathological characteristics of an SFT include spindle cells and collagen fibers ( 27 ). Immunohistochemical analysis of an SFT demonstrates the expression of vimentin, CD34, STAT6 and CD99, and in some cases, Bcl-2 and β-catenin ( 22-24 , 27-32 ).…”

“…Histopathological characteristics of an SFT include spindle cells and collagen fibers ( 27 ). Immunohistochemical analysis of an SFT demonstrates the expression of vimentin, CD34, STAT6 and CD99, and in some cases, Bcl-2 and β-catenin ( 22-24 , 27-32 ). In addition, previous studies have demonstrated that STAT6 nuclear protein and the NAB2-STAT6 fusion gene are regarded as more precise tools for SFT diagnosis ( 5 ).…”

“…At present, the preferred treatment option for SFTs is the complete surgical removal of the tumor ( 27 ). However, metastasis and recurrence may still occur, despite the ongoing development of this therapeutic approach ( 27 ).…”

“…At present, the preferred treatment option for SFTs is the complete surgical removal of the tumor ( 27 ). However, metastasis and recurrence may still occur, despite the ongoing development of this therapeutic approach ( 27 ). To date, the clinical benefits of adjuvant chemotherapy and radiation for the treatment of SFTs remain unclear ( 33 ).…”