Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report

Journal of Medical Case Reports

Zubin M Bamboat²  Patrice Hassoun¹  Donald A McCain²  Zena Jameel¹  Jordan Dozier² 

[1] Department of Pathology, Hackensack University Medical Center, 30 Prospect Avenue, Hackensack 07601A, NJ, USA;Department of Surgery, Division of Surgical Oncology, Hackensack University Medical Center, 20 Prospect Avenue, Hackensack 07601, NJ, USA

关键词: High grade sarcoma;    Mesenchymal neoplasm;    Solitary fibrous tumor;   

Others  :  1145413
DOI  :  10.1186/s13256-014-0505-4

 received in 2014-07-14, accepted in 2014-12-26,  发布年份 2015

【 摘 要 】

Introduction

Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. While they frequently arise from the pleura, they can occur at any soft tissue site in the body. We present a case of a large (28 × 21cm) malignant solitary fibrous tumor arising from the bladder serosa. In addition, the clinicopathologic features, differential diagnosis, cytogenetics and management of this rare disease are discussed, along with a review of the existing literature on this topic.

Case presentation

An otherwise healthy 41-year-old Caucasian man presented with weight loss and progressive abdominal bloating. A subsequent computed tomography scan of his chest, abdomen and pelvis revealed a 26.8 × 21cm intra-abdominal mass occupying most of his abdominal cavity. The inferior vena cava was compressed, and the mass extended inferiorly to his upper pelvis abutting the superior dome of his bladder. He underwent operative resection and the resected mass measured 28 × 21 × 18cm and weighed 4.8kg. The cut surface revealed a gray-white mass with an ill-defined whorled-like pattern, with randomly assorted tan fleshy nodules. A histologic evaluation revealed variable, alternating hypercellular and hypocellular areas, with areas of necrosis. The tumor cells varied from spindle to epithelioid within a hyalinized stroma. In the hypercellular areas, the tumor cells showed moderate atypia with high mitotic activity. The histological features combined with immunophenotyping were suggestive of a malignant solitary fibrous tumor that grossly appeared to be growing from the bladder serosa, specifically the intraperitoneal superior dome of the bladder. Our patient is currently eight months post-surgery without evidence of recurrence.

Conclusions

Extrapleural occurrences of solitary fibrosis tumors are being increasingly observed. Malignant solitary fibrosis tumors of the urinary bladder, however, are very rare. As there are no pathognomonic features of malignancy, surgical resection is often both diagnostic and therapeutic, as was the case in our report.

【 授权许可】

   
2015 Dozier et al.; licensee BioMed Central.

【 图 表 】

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