Solitary Fibrous Tumor of the Pelvis Treated with Preoperative Embolization and Pelvic Exenteration

Zerón-Medina, Jorge; Rodríguez-Covarrubias, Francisco; García-Mora, Arturo; Guerrero‐Hernández, Manuel; Chablé-Montero, Fredy; Albores‐Saavedra, Jorge; Medina‐Franco, Heriberto

doi:10.1177/000313481107700134

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…Xue et al ( 25 ) described a case of non-recurrent malignant SFT of the nasal and paranasal areas, and found that the combination of cytoreductive surgery with intensity-modulated radiation and stereotactic body radiation therapies have a good result. Studies have also demonstrated that preoperative embolization may be employed prior to surgical resection for highly vascular tumors ( 26 , 27 ). Immunotherapy, for example with interferon, may also be effective ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of 47 cases of solitary fibrous tumor

Chen

et al. 2016

Oncology Letters

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The aim of the present study was to summarize the clinical manifestations, diagnosis, treatment, and prognosis of solitary fibrous tumor (SFT). In total, 47 cases of SFTs diagnosed by postoperative pathology between January 2002 and September 2014 were retrospectively reviewed, and the general information, clinical manifestations, imaging techniques, treatment, pathology and follow-up findings were analyzed. Of the 47 patients, clinical characteristics were collected in 37 cases (18 men and 19 women; mean age, 44.1 years; age range, 13–72 years). The maximum diameters of the tumors were 1.5–25 cm, with a mean diameter of 8.8 cm. The symptoms were various and non-specific. Imaging examinations following iodinated contrast administration showed the SFTs to be well-defined, cystic or solid mass and enhanced. On color Doppler ultrasound, SFTs were described as hypoechoic, clear, irregular masses. All patients underwent surgical resection, and SFT was diagnosed by postoperative pathological and immunohistochemical examination. Of the 47 patients, 25 received complete follow-up of 5–130 months, with a median follow-up period of 35.2 months, that included a color Doppler ultrasound or computed tomography (CT) scan every 6–12 months. At the end of the follow-up period all patients were alive and healthy, with the exception of one patient, who presented with recurrence 15 months after surgery. The findings of the present study showed SFT to be a rare systemic disease with no particular clinical manifestations. In the cases reviewed in the present study, CT, magnetic resonance imaging scans and color Doppler ultrasound were important for the diagnosis of SFT, while the definitive diagnosis relied on pathological and immunohistochemical examinations. Surgery, the primary treatment for SFT, was performed, and, following complete removal of the tumor, the prognosis was favorable.

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Section: Discussionmentioning

confidence: 99%

Clinical analysis of 47 cases of solitary fibrous tumor

Chen

et al. 2016

Oncology Letters

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“…When performing TAE for SFTs, we should be aware of complications related to ischemia. Some authors have described the use of preoperative TAE with no complications in abdominopelvic SFTs irrigated by the iliac artery [ 7 , 8 ]. In our patient, the tumor was also supplied from the bilateral iliac artery, but the dominant vascularity was the inferior mesenteric artery.…”

Section: Discussionmentioning

confidence: 99%

A giant pelvic solitary fibrous tumor with Doege–Potter syndrome successfully treated with transcatheter arterial embolization followed by surgical resection: a case report

et al. 2020

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Background Solitary fibrous tumor (SFT), a mesenchymal fibroblastic tumor with a hypervascular nature, rarely develops in the pelvis. Resection of a giant SFT occupying the pelvic cavity poses an increased risk of developing massive hemorrhage during resection, although surgical resection is the most effective treatment method for this tumor to achieve a potential cure. SFT rarely develops with Doege–Potter syndrome, which is known as a paraneoplastic syndrome characterized by non-islet cell tumor hypoglycemia (NICTH) secondary to SFT that secretes insulin-like growth factor-II (IGF-II). We present a case of a giant pelvic SFT with Doege–Potter syndrome, which was successfully treated with transcatheter arterial embolization (TAE) followed by surgical resection. Case presentation A 46-year-old woman presented with a disorder of consciousness due to refractory hypoglycemia. Images of the pelvis showed a giant and heterogeneously hypervascular mass displacing and compressing the rectum. Endocrinological evaluation revealed low serum levels of insulin and C-peptide consistent with NICTH. Angiography identified both the inferior mesenteric artery and the bilateral internal iliac artery as the main feeders of the tumor. To avoid intraoperative massive bleeding, super-selective TAE was performed for the tumor 2 days prior to surgery. Hypoglycemia disappeared after TAE. The tumor was resected completely, with no massive hemorrhage during resection. Histologically, it was diagnosed as IGF-II-secreting SFT. Partial necrosis of the rectum in the specimen was observed due to TAE. The patient was followed up for 2 years and no evidence of disease has been reported. Conclusions Preoperative angiography followed by TAE is an exceedingly helpful method to reduce intraoperative hemorrhage when planning to resect SFT occupying the pelvic cavity. Complications related to ischemia should be kept in mind after TAE, which needs to be planned within 1 or 2 days before surgery. TAE for tumors may be an option in addition to medical and surgical treatment for persistent hypoglycemia in Doege–Potter syndrome.

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“…Unlike the approached described above, preoperative percutaneous embolization of feeding arteries has been shown to allow a safe, complete resection to be performed, especially in cases of thoracic, cervical, and spinal SFTs [ 14 - 16 ]. In the case of abdominopelvic SFTs, a few reports have described but not emphasized the use of preoperative embolization, and most other reports have not discussed its importance [ 6 , 17 ]. The resection of giant pelvic tumors, even if they are benign, is usually complicated by difficulties in visualizing the operative field, and the resection of giant pelvic hypervascular tumors such as SFTs is sometimes very dangerous.…”

Section: Discussionmentioning

confidence: 99%

Giant solitary fibrous tumor of the pelvis successfully treated with preoperative embolization and surgical resection: a case report

et al. 2015

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Solitary fibrous tumors (SFTs) rarely develop in the pelvis. When they do arise, they are usually treated using surgery, although SFTs are often very large by the time of diagnosis, which makes surgical excision difficult. We report a case of a 63-year-old man who was referred to our hospital for the treatment of a giant tumor of the pelvis. Computed tomography (CT) revealed a 30 × 25 × 19 cm sized hypervascular tumor that almost completely filled the pelvic cavity. The diagnosis of SFT was made by CT-assisted needle biopsy. The feeding arteries of the tumor were embolized twice. The first embolization aimed to reduce the tumor volume, while the second one was planned a day prior to the surgery to obtain hematostasis during the operation. Tumor resection was then performed. The blood loss during the operation was 440 ml, and there was no uncontrollable bleeding. The postoperative course was uneventful. No recurrence of SFT was observed during a 2-year follow-up.

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Solitary Fibrous Tumor of the Pelvis Treated with Preoperative Embolization and Pelvic Exenteration

Cited by 5 publications

References 4 publications

Clinical analysis of 47 cases of solitary fibrous tumor

Clinical analysis of 47 cases of solitary fibrous tumor

A giant pelvic solitary fibrous tumor with Doege–Potter syndrome successfully treated with transcatheter arterial embolization followed by surgical resection: a case report

Giant solitary fibrous tumor of the pelvis successfully treated with preoperative embolization and surgical resection: a case report

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