Solitary fibrous tumor of male breast: A case report and literature review

Abstract

Background: Solitary fibrous tumors (SFT) are uncommon mesenchymal neoplasms which can arise in any anatomical location. Pleural SFTs have been most frequently documented; however, breast SFT is an exceedingly rare entity and seldom present in male breast, with only 8 previously reported cases. Recently, STAT6 immunostaining was considered to be a definitive marker of SFT, however, no case of the male breast SFT showing STAT6 positivity preoperatively has been reported. Methods and Results: We describe a case of breast SFT in a 73-year-old male patient with a 12-month history of a palpable breast mass. The only associated clinical symptom was bilateral gynecomastia. An ultrasound scan examination revealed an oval, well-circumscribed and hypoechoic mass with hypervascularity. A core-needle biopsy was performed, and microscopic examination with immunohistochemistry confirmed the diagnosis of SFT. He underwent a complete surgical resection with clear margins, and there were no signs of high cellularity, remarkable mitotic activity, pleomorphism, hemorrhage or necrosis. Conclusion: A perioperative immunohistochemical evaluation for diffuse and intense nuclear expression of STAT6 was helpful to distinguish SFT from myofibroblastoma. We, herein, describe the first case of SFT in a male breast, confirmed by STAT6 immunostaining positivity. We also conducted a literature review of all previous cases of breast SFTs.

A giant breast malignant solitary fibrous tumor: A rare case report and brief review

“…To date, only 33 cases of breast SFTs, including 5 malignant tumors, have been reported (6). In the present report, a rare case of a 48-year-old female patient with a large tumor confirmed to be a malignant SFT is reported.…”

“…Concurrently, surgical management can help preserve critical surrounding organs. According to previous case reports (6,24), 31/33 patients (93.9%) underwent complete surgical resection and showed a negative margin, whereas 2 patients underwent mastectomy during the primary surgery. However, despite R0 margins, 2 patients (6.3%) with breast SFTs showed recurrence and required a second surgery; one malignant tumor was removed using mastectomy and a second benign tumor was resected with a negative margin (24,25).…”

“…The precise incidence rate of breast SFTs is difficult to illustrate. Breast SFTs appear to be more common in female (24 cases) than male (9 cases) patients, whereas in the pleura and central nervous system SFTs have similar distribution between male and female patients (6). This difference may be attributed to the specific epicenter of SFTs.…”

“…Neither environmental nor hereditary factors have been shown to increase the incidence rate of SFTs. SFTs are often slow-growing tumors, and are frequently diagnosed based on incidental radiological or accidental findings of painless palpable masses of varying sizes (range, 0.6-10 cm) (6). Pain, nipple discharge or enlarged regional lymph nodes are usually not observed in patients with SFTs (7).…”

Incidental finding of solitary fibrous tumor of male breast: case report and review of literature

“…Although tumors of the male breast are rare, it is rare to find a lesion in itself. Therefore, it is a combination of rarity that poses a dilemma for diagnosis and treatment [ 4 , 5 ].…”