Malignant solitary fibrous tumor of the pancreas: a case report
Abstract Background Solitary fibrous tumors (SFTs) are rare tumors, mostly derived from connective tissue mesenchymal cells that arise from the pleura. There are very few reports of primary pancreatic SFT. Preoperative diagnosis is difficult owing to the lack of distinctive radiological findings. We...
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Japan Surgical Society
2020-11-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-020-01067-6 |
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| author | Yuka Taguchi Takanobu Hara Hiroaki Tamura Masahito Ogiku Mana Watahiki Toru Takagi Takashi Harada Shinichiro Miyazaki Tadataka Hayashi Toshikazu Kanai Hiroki Mori Takachika Ozawa Yoshiro Nishiwaki |
| author_facet | Yuka Taguchi Takanobu Hara Hiroaki Tamura Masahito Ogiku Mana Watahiki Toru Takagi Takashi Harada Shinichiro Miyazaki Tadataka Hayashi Toshikazu Kanai Hiroki Mori Takachika Ozawa Yoshiro Nishiwaki |
| author_sort | Yuka Taguchi |
| collection | DOAJ |
| description | Abstract Background Solitary fibrous tumors (SFTs) are rare tumors, mostly derived from connective tissue mesenchymal cells that arise from the pleura. There are very few reports of primary pancreatic SFT. Preoperative diagnosis is difficult owing to the lack of distinctive radiological findings. We report a case of pancreatic SFT with particularly rare malignant findings. Case presentation A 60-year-old man was referred to the hospital because of a right upper quadrant mass and abnormal liver function test results. Contrast-enhanced computed tomography (CT) showed a well-defined enhanced tumor measuring approximately 8 cm in the pancreatic head. Magnetic resonance imaging (MRI) showed T1WI hypointensity, T2WI hyperintensity, and DWI hyperintensity. The main pancreatic duct and common bile duct were dilated owing to obstruction by the tumor. The following tumor markers were mildly elevated: carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), SPan-1, and DUPAN-2. The histological diagnosis obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was negative for pancreatic ductal carcinoma, malignant lymphoma and neuroendocrine tumor, suggesting the possibility of mesenchymal tumor, but the diagnosis was not confirmed. The patient was judged suitable for surgery and underwent subtotal stomach-preserving pancreatoduodenectomy with D2 lymph node dissection. On histopathological examination of the resected specimen, infiltrating spindle-shaped cells had proliferated, containing numerous mitotic figures, with necrotic findings inside the tumor. Immunostaining was positive for cluster of differentiation-34 (CD34), B cell CLL/lymphoma-2 (Bcl-2), and signal transducer and activator of transcription (STAT6). On the basis of these findings, a diagnosis of malignant pancreatic SFT was made. The patient remains free of recurrent disease after 12 months of follow-up without adjuvant therapy and he is being carefully followed up as an outpatient. Conclusions We experienced a case of malignant pancreatic head SFT. Immunohistochemical staining of the extracted specimens was useful for diagnosis. |
| format | Article |
| id | doaj-art-69ce60e95a774124b9616488ff9cfc7d |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-69ce60e95a774124b9616488ff9cfc7d2025-08-20T02:52:03ZengJapan Surgical SocietySurgical Case Reports2198-77932020-11-01611910.1186/s40792-020-01067-6Malignant solitary fibrous tumor of the pancreas: a case reportYuka Taguchi0Takanobu Hara1Hiroaki Tamura2Masahito Ogiku3Mana Watahiki4Toru Takagi5Takashi Harada6Shinichiro Miyazaki7Tadataka Hayashi8Toshikazu Kanai9Hiroki Mori10Takachika Ozawa11Yoshiro Nishiwaki12Department of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterDepartment of Pathology, Hamamatsu Medical CenterDepartment of Pathology, Hamamatsu Medical CenterDepartment of Gastroenterological Surgery, Hamamatsu Medical CenterAbstract Background Solitary fibrous tumors (SFTs) are rare tumors, mostly derived from connective tissue mesenchymal cells that arise from the pleura. There are very few reports of primary pancreatic SFT. Preoperative diagnosis is difficult owing to the lack of distinctive radiological findings. We report a case of pancreatic SFT with particularly rare malignant findings. Case presentation A 60-year-old man was referred to the hospital because of a right upper quadrant mass and abnormal liver function test results. Contrast-enhanced computed tomography (CT) showed a well-defined enhanced tumor measuring approximately 8 cm in the pancreatic head. Magnetic resonance imaging (MRI) showed T1WI hypointensity, T2WI hyperintensity, and DWI hyperintensity. The main pancreatic duct and common bile duct were dilated owing to obstruction by the tumor. The following tumor markers were mildly elevated: carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), SPan-1, and DUPAN-2. The histological diagnosis obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was negative for pancreatic ductal carcinoma, malignant lymphoma and neuroendocrine tumor, suggesting the possibility of mesenchymal tumor, but the diagnosis was not confirmed. The patient was judged suitable for surgery and underwent subtotal stomach-preserving pancreatoduodenectomy with D2 lymph node dissection. On histopathological examination of the resected specimen, infiltrating spindle-shaped cells had proliferated, containing numerous mitotic figures, with necrotic findings inside the tumor. Immunostaining was positive for cluster of differentiation-34 (CD34), B cell CLL/lymphoma-2 (Bcl-2), and signal transducer and activator of transcription (STAT6). On the basis of these findings, a diagnosis of malignant pancreatic SFT was made. The patient remains free of recurrent disease after 12 months of follow-up without adjuvant therapy and he is being carefully followed up as an outpatient. Conclusions We experienced a case of malignant pancreatic head SFT. Immunohistochemical staining of the extracted specimens was useful for diagnosis.http://link.springer.com/article/10.1186/s40792-020-01067-6Solitary fibrous tumorPancreasMalignantSurgery |
| spellingShingle | Yuka Taguchi Takanobu Hara Hiroaki Tamura Masahito Ogiku Mana Watahiki Toru Takagi Takashi Harada Shinichiro Miyazaki Tadataka Hayashi Toshikazu Kanai Hiroki Mori Takachika Ozawa Yoshiro Nishiwaki Malignant solitary fibrous tumor of the pancreas: a case report Surgical Case Reports Solitary fibrous tumor Pancreas Malignant Surgery |
| title | Malignant solitary fibrous tumor of the pancreas: a case report |
| title_full | Malignant solitary fibrous tumor of the pancreas: a case report |
| title_fullStr | Malignant solitary fibrous tumor of the pancreas: a case report |
| title_full_unstemmed | Malignant solitary fibrous tumor of the pancreas: a case report |
| title_short | Malignant solitary fibrous tumor of the pancreas: a case report |
| title_sort | malignant solitary fibrous tumor of the pancreas a case report |
| topic | Solitary fibrous tumor Pancreas Malignant Surgery |
| url | http://link.springer.com/article/10.1186/s40792-020-01067-6 |
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