Korean J Gastroenterol.  2023 Aug;82(2):96-101. 10.4166/kjg.2023.053.

Solitary Fibrous Tumors of the Mesocolon: A Report of Two Cases and Review of Literature

• Pardasani MM
• Nekarakanti PK
• Nagari B
• Gunturi SRV
• Bansal AK
• Uppin SG

• KMID: 2545334
• DOI: http://doi.org/10.4166/kjg.2023.053

Abstract

Solitary fibrous tumors (SFTs) are an uncommon group of neoplasms. The visceral pleura is the most common site of origin of these tumors. The colonic mesentery is an unusual site of origin of SFTs. A pre-operative diagnosis of SFT is challenging as there are no pathognomonic clinical or radiological signs. Most patients reported thus far were diagnosed post-operatively with the aid of immunohistochemical markers. Complete surgical excision is the treatment of choice for SFTs. Recurrences are uncommon. However, they can occasionally show aggressive behavior. In this report, we describe two cases of rare colonic mesentery SFTs.

Keyword

Solitary fibrous tumor; Mesocolon

Figure

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  Fig. 1 (A) Contrast-enhanced computed tomography showing a heterogeneously enhancing mass with lobulated margins and central necrotic components. (B) Specimen showing distal pancreatectomy and splenectomy along with the resected segment of the colon.

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  Fig. 2 (A) H&E sections reveal a higher magnification of the cellular area of the tumor showing closely packed cells with little intervening collagenous stroma. Tumor cells have oval to slightly elongated bland nuclei with fine pale chromatin and inconspicuous nucleoli. The cytoplasm is scant to moderate, pale eosinophilic with indistinct borders (×400). (B) Higher magnification of the hypocellular area of the tumor showing prominent hyalinised (keloid-like) collagenous stroma with relatively few tumor cells (×400). Immunohistochemical findings of the tumor. (C) CD34 and (D) STAT6 shows diffuse cytoplasm and nucleus (with some cytoplasmic staining) in the tumor cells respectively (HRP-Polymer; ×400). (E) Immunohistochemical staining with Ki-67 labels occasional tumor cell nuclei indicating low proliferative activity within the tumor (HRP-Polymer; ×400).

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  Fig. 3 (A) Contrast-enhanced computed tomography showing a heterogeneously enhancing mass occupying the pelvis. (B) Post-operative specimen showing the resected recto-sigmoid colon with the adjacent tumor.

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  Fig. 4 Hematoxylin and esosin staining. (A) Cells arranged in fascicles separated by collagen (magnification ×100). (B) Cellular lesion with a hemangiopericytomatous pattern; immuno-histochemical staining (magnificantion ×400). (C) Nuclear positivity for STAT6 (HRP-Polymer; ×400). (D) Tumor cell positivity for CD34 (HRP-Polymer; ×400). (E) Low Ki67 index (HRP-Polymer; ×400).

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