A locally aggressive solitary fibrous tumor of the leg: Case report and literature review

Abstract

Introduction: The solitary fibrous tumor (SFT) is a rare soft tissue tumor with a substantially benign clinical behavior. However, malignant neoplasms with local recurrence or distant metastases have been reported.

Presentation of the case: The authors present a case of an aggressive SFT of the leg, in a 55 years old Caucasian man. Radiological, histological and molecular findings are reported. The differential diagnosis, therapy and outcome of this rare tumor are also discussed.

Discussion: An extensive review of literature showed SFT's clinical behavior as substantially benign, anyway aggressive or malignant neoplasms have been described. The potential risk of local recurrence and distant metastasis thus suggests wide surgical resection and careful long-term follow-up. Differential diagnosis may be quite laborious as SFT can mimic a variety of benign and malignant mesenchymal tumors; immunohistochemical analysis for CD34, CD99, vimentin and bcl-2 is then mandatory.

Conclusion: Our clinical experience confirmed that SFT may have an aggressive behavior, however, conservative surgical treatment may be successful in the long term.

Fig. 1

Magnetic resonance 3D reconstruction of deep plane: three quarters view.

Fig. 2

Microscopic histology image of the neoplasm.

Fig. 3

Pre-operative lateral view of the left leg.

Fig. 4

Intra-operative view of the neoplasm en bloc excision including the above skin paddle.

Fig. 5

Post-operative lateral view dorsal flexion.