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Revista de la Asociación Médica del Centro Médico ABC

2021, Number 4

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An Med Asoc Med Hosp ABC 2021; 66 (4)

Retroperitoneal solitary fibrous tumor: case report and review of literature

Rivera GGA, Robles VCD, Kajomovitz BD

Language: Spanish
References: 10
Page: 292-296
PDF size: 316.67 Kb.


ABSTRACT

Solitary fibrous tumors are rare tumors of mesenchymal origin, most commonly found in the thorax, although 34% of them are extrathoracic. We present a case of a 56-year-old female; a CT scan was done because of appendicitis, which reported a left para-aortic retroperitoneal solid-cystic lesion that measured 94 × 59 × 143 mm. Upon direct questioning, she denied the presence of abdominal symptoms, lumbar pain, weight change, or any other symptom. A biopsy was taken by interventional radiology that reported a solitary fibrous tumor. After discussion with a multidisciplinary team, a surgical resolution was decided. An exploratory laparotomy was performed, where a 16 × 7 cm tumor was found in close relationship to the aorta, left iliac artery, and left ureter, with tributary vessels from a lumbar and inferior mesenteric artery. The patient presented an adequate postoperative evolution, and she was discharged on her fifth postoperative day. Histopathology examination reported a solitary fibrous tumor, histological grade 1 (FNCLCC), with one mitosis per 10 high power fields, without necrosis. The most frequent age of diagnosis of a solitary fibrous tumor is between the fifth and sixth decade of life, with an equal incidence between men and women. Symptoms depend on location and size and are frequently because of compression to adjacent structures. The treatment of this pathology consists of an en bloc R0 surgical resection. Obtaining negative margins is imperative because even though it is considered a benign tumor, there is a risk of malignancy, and positive margins are the most frequent cause of metastasic recurrence. Malignancy risk is determined by unfavorable histopathology and size.


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