Determination of biological behavior of solitary fibrous tumors: correlation of expression of Ki-67, TPX2 and TERT mRNA subunit level and NAB2-STAT6 fusion compared to morphological aspects of SFTs

Krsková, Lenka; Odintsov, Igor; Fabián, Ondřej; Hroudová, Petra; Mrhalová, Marcela

doi:10.4149/neo_2021_210511n642

Cited by 7 publications

(7 citation statements)

References 32 publications

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“…NAB2-STAT6 fusion is a driver mutation in SFT, where transcriptional repressors of the cytokinesis pathway are converted into transcriptional activators [31,38,39]. STAT6 has a sensitivity of 98% and a speci city of 85% for SFT and is therefore considered the most characteristic SFT marker [40,41]. In our case, the tumor was positive for STAT6, while CD34, bc1-2, vimentin, and CD99 were positive.…”

Section: Discussionmentioning

confidence: 54%

“…The histopathological features of malignant SFT are (i) hypercellularity, (ii) more than four mitotic gures per ten high-power elds, (iii) nuclear pleomorphism, (iv) hemorrhage and necrosis, (v) tumor diameter ≥ 10 cm, and (vi) positive margins [15,21,46]. Ki-67 can also differentiate benign from malignant tumors, with a cutoff value of 0-5% (indeterminate in 5-10%) for benign tumors and > 10% for malignant SFTs [40,47]. In our case, our patient had a Ki-67 proliferation index of 40%; therefore, the tumor was possibly malignant.…”

Section: Discussionmentioning

confidence: 99%

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Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: a literature review

Wang¹,

Zhou²,

et al. 2023

Preprint

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Background Solitary fibrous tumor (SFT) is often located in the pleura, while SFT of the pancreas is extremely rare. Here, we report a case of SFT of the pancreas and discuss imaging, histopathology, and immunohistochemistry for accurate diagnosis and treatment. Case presentation A 54-year-old man presented to our hospital with pancreatic occupancy for over a month. There were no previous complaints of discomfort. His blood pressure was normal. Blood glucose, tumor markers, and enhanced computed tomography (CT) suggested a malignant tumor. Because the CT appearance of pancreatic cancer varies, we could not confirm the diagnosis; therefore, we performed a puncture biopsy under ultrasound endoscopy. Pathology and immunohistochemistry were consistent with SFT of the pancreas. The postoperative pathology and immunohistochemistry were consistent with the puncture results. The patient presented for a follow-up examination one month after discharge with no adverse effects. Discussion Other diseases must be excluded in patients with a pancreatic mass that cannot be diagnosed. CT and pathological histology have diagnostic value for pancreatic tumors. Endoscopic puncture biopsy under ultrasound can help diagnose pancreatic masses that cannot be diagnosed preoperatively. Surgery is an effective treatment for SFT of the pancreas; however, long-term follow-up is strongly recommended because of the possibility of malignant transformation of the tumor.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: a literature review

Wang¹,

Zhou²,

et al. 2023

Preprint

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“…Patients with high Ki67 had a significantly higher risk of metastasis within 5 years of surgery and furthermore, the authors substituted mitotic index with Ki67-index in Demiccos RSS, and found it to be potentially superior ( 31 ). We found more studies in which high Ki67 was associated with adverse outcome ( 63 , 64 ), however Ki67 cut-off values differed from ≥2% ( 39 ), ≥5% ( 30 ), ≥10% ( 10 , 19 , 65 ) and ≥12% ( 25 ).…”

Section: Resultsmentioning

confidence: 93%

Risk factors for recurrent disease after resection of solitary fibrous tumor: a systematic review

Tolstrup,

Loya,

Aggerholm-Pedersen

et al. 2024

Front. Surg.

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IntroductionSolitary fibrous tumor (SFT) is a rare soft tissue tumor found at any site of the body. The treatment of choice is surgical resection, though 10%–30% of patients experience recurrent disease. Multiple risk factors and risk stratification systems have been investigated to predict which patients are at risk of recurrence. The main goal of this systematic review is to create an up-to-date systematic overview of risk factors and risk stratification systems predicting recurrence for patients with surgically resected SFT within torso and extremities.MethodWe prepared the review following the updated Prisma guidelines for systematic reviews (PRISMA-P). Pubmed, Embase, Cochrane Library, WHO international trial registry platform and ClinicalTrials.gov were systematically searched up to December 2022. All English studies describing risk factors for recurrence after resected SFT were included. We excluded SFT in the central nervous system and the oto-rhino-laryngology region.ResultsEighty-one retrospective studies were identified. Different risk factors including age, symptoms, sex, resection margins, anatomic location, mitotic index, pleomorphism, hypercellularity, necrosis, size, dedifferentiation, CD-34 expression, Ki67 index and TP53-expression, APAF1-inactivation, TERT promoter mutation and NAB2::STAT6 fusion variants were investigated in a narrative manner. We found that high mitotic index, Ki67 index and presence of necrosis increased the risk of recurrence after surgically resected SFT, whereas other factors had more varying prognostic value. We also summarized the currently available different risk stratification systems, and found eight different systems with a varying degree of ability to stratify patients into low, intermediate or high recurrence risk.ConclusionMitotic index, necrosis and Ki67 index are the most solid risk factors for recurrence. TERT promoter mutation seems a promising component in future risk stratification models. The Demicco risk stratification system is the most validated and widely used, however the G-score model may appear to be superior due to longer follow-up time.Systematic Review RegistrationCRD42023421358.

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“…NAB2-STAT6 fusion is a driver mutation in SFT, where transcriptional repressors of the cytokinesis pathway are converted into transcriptional activators[ 31 , 38 , 39 ]. STAT6 has a sensitivity of 98% and a specificity of 85% for SFT and is therefore considered the most characteristic SFT marker[ 40 , 41 ]. In our case, the tumor was positive for STAT6, while CD34, bc1-2, vimentin, and CD99 were positive.…”

Section: Discussionmentioning

confidence: 99%

“…The histopathological features of malignant SFT: (1) Hypercellularity; (2) more than four mitotic figures per ten high-power fields; (3) nuclear pleomorphism; (4) hemorrhage and necrosis; (5) tumor diameter ≥10 cm; and (6) positive margins[ 15 , 21 , 46 ]. Ki-67 can also differentiate benign from malignant tumors, with a cutoff value of 0%-5% (indeterminate in 5%-10%) for benign tumors and > 10% for malignant SFTs[ 40 , 47 ]. In our case, our patient had a Ki-67 proliferation index of 40%; therefore, the tumor was possibly malignant.…”

Section: Discussionmentioning

confidence: 99%

Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: A case report and review of literature

Wang,

Zhou,

et al. 2024

World J Clin Cases

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BACKGROUND A solitary fibrous tumor (SFT) is often located in the pleura, while SFT of the pancreas is extremely rare. Here, we report a case of SFT of the pancreas and discuss imaging, histopathology, and immunohistochemistry for accurate diagnosis and treatment. CASE SUMMARY A 54-year-old man presented to our hospital with pancreatic occupancy for over a month. There were no previous complaints of discomfort. His blood pressure was normal. Blood glucose, tumor markers, and enhanced computed tomography (CT) suggested a malignant tumor. Because the CT appearance of pancreatic cancer varies, we could not confirm the diagnosis; therefore, we performed endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). Pathology and immunohistochemistry were consistent with SFT of the pancreas. The postoperative pathology and immunohistochemistry were consistent with the puncture results. The patient presented for a follow-up examination one month after discharge with no adverse effects. CONCLUSION Other diseases must be excluded in patients with a pancreatic mass that cannot be diagnosed. CT and pathological histology have diagnostic value for pancreatic tumors. Endoscopic puncture biopsy under ultrasound can help diagnose pancreatic masses that cannot be diagnosed preoperatively. Surgery is an effective treatment for SFT of the pancreas; however, long-term follow-up is strongly recommended because of the possibility of malignant transformation of the tumor.

show abstract

Determination of biological behavior of solitary fibrous tumors: correlation of expression of Ki-67, TPX2 and TERT mRNA subunit level and NAB2-STAT6 fusion compared to morphological aspects of SFTs

Cited by 7 publications

References 32 publications

Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: a literature review

Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: a literature review

Risk factors for recurrent disease after resection of solitary fibrous tumor: a systematic review

Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: A case report and review of literature

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