Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review
IntroductionSolitary Fibrous Tumor (SFT) is a rare mesenchymal tumor characterized by CD34-positive dendritic stromal cells that can differentiate into fibroblasts or myofibroblasts. Although commonly found in the pleura, these tumors can also occur in other locations, including the retroperitoneum,...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1531597/full |
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| author | Dong-Mei Li Dong-Mei Li Dan Tang Dan Tang Ming-Rong Qie Ming-Rong Qie Min-Min Hou Min-Min Hou |
| author_facet | Dong-Mei Li Dong-Mei Li Dan Tang Dan Tang Ming-Rong Qie Ming-Rong Qie Min-Min Hou Min-Min Hou |
| author_sort | Dong-Mei Li |
| collection | DOAJ |
| description | IntroductionSolitary Fibrous Tumor (SFT) is a rare mesenchymal tumor characterized by CD34-positive dendritic stromal cells that can differentiate into fibroblasts or myofibroblasts. Although commonly found in the pleura, these tumors can also occur in other locations, including the retroperitoneum, where a subset may show malignant behavior, leading to local invasion and metastasis.Case presentationWe report the case of a 60-year-old woman with progressive abdominal distension (3 months) and dysuria (2 months). Imaging revealed a 7.6cm × 10.1cm × 10.7cm right pelvic mass compressing the ureter and bladder. Surgical resection of the firm, hypervascular uterine mass with infiltrative margins was achieved. Immunohistochemistry demonstrated diffuse positivity for CD34, STAT6, Bcl-2, CD99, SW-1 and ER, with focal TP53 expression and 10% Ki-67 index, confirming malignant solitary fibrous tumor. Early postoperative surveillance MRI at one month detected local recurrence with regional lymph node metastases. Given the tumor’s aggressive biology, high operative risk for re-intervention, and lack of effective systemic therapy options, a multidisciplinary team recommended transition to palliative care. The patient remains alive after following up 8 months.ConclusionNeoadjuvant radiotherapy may benefit high-risk SFT cases nearing the limits of resectability, but current evidence highlights the challenges in managing aggressive pelvic malignant SFTs and emphasizes the need for ongoing research into effective treatment options while also aiming to stimulate discussion among scholars and encourage the sharing of experiences from similar cases to provide valuable insights for future diagnosis and treatment of malignant SFTs. |
| format | Article |
| id | doaj-art-ab3dc445ca8e4312b1e3632e68b89578 |
| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-ab3dc445ca8e4312b1e3632e68b895782025-08-20T02:29:20ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15315971531597Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature reviewDong-Mei Li0Dong-Mei Li1Dan Tang2Dan Tang3Ming-Rong Qie4Ming-Rong Qie5Min-Min Hou6Min-Min Hou7Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaIntroductionSolitary Fibrous Tumor (SFT) is a rare mesenchymal tumor characterized by CD34-positive dendritic stromal cells that can differentiate into fibroblasts or myofibroblasts. Although commonly found in the pleura, these tumors can also occur in other locations, including the retroperitoneum, where a subset may show malignant behavior, leading to local invasion and metastasis.Case presentationWe report the case of a 60-year-old woman with progressive abdominal distension (3 months) and dysuria (2 months). Imaging revealed a 7.6cm × 10.1cm × 10.7cm right pelvic mass compressing the ureter and bladder. Surgical resection of the firm, hypervascular uterine mass with infiltrative margins was achieved. Immunohistochemistry demonstrated diffuse positivity for CD34, STAT6, Bcl-2, CD99, SW-1 and ER, with focal TP53 expression and 10% Ki-67 index, confirming malignant solitary fibrous tumor. Early postoperative surveillance MRI at one month detected local recurrence with regional lymph node metastases. Given the tumor’s aggressive biology, high operative risk for re-intervention, and lack of effective systemic therapy options, a multidisciplinary team recommended transition to palliative care. The patient remains alive after following up 8 months.ConclusionNeoadjuvant radiotherapy may benefit high-risk SFT cases nearing the limits of resectability, but current evidence highlights the challenges in managing aggressive pelvic malignant SFTs and emphasizes the need for ongoing research into effective treatment options while also aiming to stimulate discussion among scholars and encourage the sharing of experiences from similar cases to provide valuable insights for future diagnosis and treatment of malignant SFTs.https://www.frontiersin.org/articles/10.3389/fonc.2025.1531597/fullmalignant solitary fibrous tumorrecurrencetreatmentlymph node metastasiscase report |
| spellingShingle | Dong-Mei Li Dong-Mei Li Dan Tang Dan Tang Ming-Rong Qie Ming-Rong Qie Min-Min Hou Min-Min Hou Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review Frontiers in Oncology malignant solitary fibrous tumor recurrence treatment lymph node metastasis case report |
| title | Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review |
| title_full | Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review |
| title_fullStr | Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review |
| title_full_unstemmed | Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review |
| title_short | Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review |
| title_sort | exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors a case report and literature review |
| topic | malignant solitary fibrous tumor recurrence treatment lymph node metastasis case report |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1531597/full |
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