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Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report
INTRODUCTION: Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. While they frequently arise from the pleura, they can occur at any soft tissue site in the body. We present a case of a large (28 × 21cm) malignant solita...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358716/ https://www.ncbi.nlm.nih.gov/pubmed/25884588 http://dx.doi.org/10.1186/s13256-014-0505-4 |
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author | Dozier, Jordan Jameel, Zena McCain, Donald A Hassoun, Patrice Bamboat, Zubin M |
author_facet | Dozier, Jordan Jameel, Zena McCain, Donald A Hassoun, Patrice Bamboat, Zubin M |
author_sort | Dozier, Jordan |
collection | PubMed |
description | INTRODUCTION: Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. While they frequently arise from the pleura, they can occur at any soft tissue site in the body. We present a case of a large (28 × 21cm) malignant solitary fibrous tumor arising from the bladder serosa. In addition, the clinicopathologic features, differential diagnosis, cytogenetics and management of this rare disease are discussed, along with a review of the existing literature on this topic. CASE PRESENTATION: An otherwise healthy 41-year-old Caucasian man presented with weight loss and progressive abdominal bloating. A subsequent computed tomography scan of his chest, abdomen and pelvis revealed a 26.8 × 21cm intra-abdominal mass occupying most of his abdominal cavity. The inferior vena cava was compressed, and the mass extended inferiorly to his upper pelvis abutting the superior dome of his bladder. He underwent operative resection and the resected mass measured 28 × 21 × 18cm and weighed 4.8kg. The cut surface revealed a gray-white mass with an ill-defined whorled-like pattern, with randomly assorted tan fleshy nodules. A histologic evaluation revealed variable, alternating hypercellular and hypocellular areas, with areas of necrosis. The tumor cells varied from spindle to epithelioid within a hyalinized stroma. In the hypercellular areas, the tumor cells showed moderate atypia with high mitotic activity. The histological features combined with immunophenotyping were suggestive of a malignant solitary fibrous tumor that grossly appeared to be growing from the bladder serosa, specifically the intraperitoneal superior dome of the bladder. Our patient is currently eight months post-surgery without evidence of recurrence. CONCLUSIONS: Extrapleural occurrences of solitary fibrosis tumors are being increasingly observed. Malignant solitary fibrosis tumors of the urinary bladder, however, are very rare. As there are no pathognomonic features of malignancy, surgical resection is often both diagnostic and therapeutic, as was the case in our report. |
format | Online Article Text |
id | pubmed-4358716 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43587162015-03-14 Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report Dozier, Jordan Jameel, Zena McCain, Donald A Hassoun, Patrice Bamboat, Zubin M J Med Case Rep Case Report INTRODUCTION: Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. While they frequently arise from the pleura, they can occur at any soft tissue site in the body. We present a case of a large (28 × 21cm) malignant solitary fibrous tumor arising from the bladder serosa. In addition, the clinicopathologic features, differential diagnosis, cytogenetics and management of this rare disease are discussed, along with a review of the existing literature on this topic. CASE PRESENTATION: An otherwise healthy 41-year-old Caucasian man presented with weight loss and progressive abdominal bloating. A subsequent computed tomography scan of his chest, abdomen and pelvis revealed a 26.8 × 21cm intra-abdominal mass occupying most of his abdominal cavity. The inferior vena cava was compressed, and the mass extended inferiorly to his upper pelvis abutting the superior dome of his bladder. He underwent operative resection and the resected mass measured 28 × 21 × 18cm and weighed 4.8kg. The cut surface revealed a gray-white mass with an ill-defined whorled-like pattern, with randomly assorted tan fleshy nodules. A histologic evaluation revealed variable, alternating hypercellular and hypocellular areas, with areas of necrosis. The tumor cells varied from spindle to epithelioid within a hyalinized stroma. In the hypercellular areas, the tumor cells showed moderate atypia with high mitotic activity. The histological features combined with immunophenotyping were suggestive of a malignant solitary fibrous tumor that grossly appeared to be growing from the bladder serosa, specifically the intraperitoneal superior dome of the bladder. Our patient is currently eight months post-surgery without evidence of recurrence. CONCLUSIONS: Extrapleural occurrences of solitary fibrosis tumors are being increasingly observed. Malignant solitary fibrosis tumors of the urinary bladder, however, are very rare. As there are no pathognomonic features of malignancy, surgical resection is often both diagnostic and therapeutic, as was the case in our report. BioMed Central 2015-03-01 /pmc/articles/PMC4358716/ /pubmed/25884588 http://dx.doi.org/10.1186/s13256-014-0505-4 Text en © Dozier et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Dozier, Jordan Jameel, Zena McCain, Donald A Hassoun, Patrice Bamboat, Zubin M Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report |
title | Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report |
title_full | Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report |
title_fullStr | Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report |
title_full_unstemmed | Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report |
title_short | Massive malignant solitary fibrous tumor arising from the bladder serosa: a case report |
title_sort | massive malignant solitary fibrous tumor arising from the bladder serosa: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358716/ https://www.ncbi.nlm.nih.gov/pubmed/25884588 http://dx.doi.org/10.1186/s13256-014-0505-4 |
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