J Liver Cancer.  2019 Sep;19(2):143-148. 10.17998/jlc.19.2.143.

Malignant Hepatic Solitary Fibrous Tumor

• Kim HI
• In SK
• Yi HS
• Lee MJ
• Kim HY

• KMID: 2463615
• DOI: http://doi.org/10.17998/jlc.19.2.143

Abstract

Hepatic solitary fibrous tumors (SFTs) are mostly benign and rare because of information regarding the clinical symptoms, treatment, and prognosis of their malignant forms is currently lacking. A literature review concerning malignant SFTs revealed that there were a few cases where patients experienced abdominal right upper quadrant (RUQ) pain as their first clinical symptom, and metastases were found after being diagnosed with hepatic SFT. Here, we report a patient who was previously healthy without any clinical symptoms such as RUQ pain or weight loss, but had the appearance of a metastatic mass as the first clinical presentation before a primary hepatic SFT was detected.

Keyword

Solitary fibrous tumors; Sarcoma; Liver neoplasms

MeSH Terms

Humans
Liver Neoplasms
Neoplasm Metastasis
Prognosis
Sarcoma
Solitary Fibrous Tumors*
Weight Loss

Figure

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  Figure 1. Abdominal computed tomography coronal view. (A) Heterogeneous intermediate density enhanced mass was observed in the right flank region (arrow). (B) An approximately 14×11×10 cm sized mass was accidentally detected in the liver.

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  Figure 2. Liver third phase magnetic resonance imaging axial view. Approximately 14×11×10 cm sized large intermediate signal intensity mass, peripheral enhanced rim with internal necrotic portion, peritumor bile duct dilatations from segment IV of the liver to the right hepatic lobe. (A) Arterial phase: early arterial enhancement. (B) Portal phase: delayed progress enhancement findings.

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  Figure 3. Histological findings. (A) Histology of the liver shows similar morphology to spindled tumor cells with a typical “staghorn” vascular pattern (arrows) (hematoxylin and eosin staining [H&E], ×100). (B) Histology of the right flank mass. The tumor cells are arranged in a “patternless” disposition with typical ectatic and irregularly shaped vessels (arrows) (H&E, ×100). (C) Histology of the right flank mass. At high power, tumors are ovoid to spindle shaped with relatively uniform and bland cytology. Increased mitotic activity (arrows) is identified (H&E, ×400). (D) CD34 immunohistochemical expression is strong and diffuse (×200).

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  Figure 4. Chest computed tomography findings with a small nodule in the left lower lobe of the lung, which was suspected to be metastasis (arrow).

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