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. 2021 Nov 3:24:101675.
doi: 10.1016/j.jcot.2021.101675. eCollection 2022 Jan.

Extra-thoracic, extra-meningeal solitary fibrous tumours - A case series and service review

R Silverwood  1 , V Jayasankar  1 , A Mahendra  1 , S Gupta  1 , E MacDuff  2
Affiliations

Extra-thoracic, extra-meningeal solitary fibrous tumours - A case series and service review

R Silverwood et al. J Clin Orthop Trauma. .

Abstract

Background: Solitary fibrous tumours (SFT) are a type of mesenchymal tumour. Whilst the majority of cases follow an indolent course a significant proportion of patients suffer metastases or disease recurrence post-surgical excision. Due to the unpredictable clinical course follow up duration and intensity remains contentious.

Aims: We aimed to determine current outcomes of management of this tumour, apply and assess current risk recurrence models to determine if our standard of care could be improved upon.

Methods and patients: A prospective database of patients treated at a regional musculoskeletal oncology service was assessed. Only extra-pleural, extra-meningeal SFTs were included in the study. Surgical outcome and post-operative investigations were scrutinised and the Pasquali and Demicco recurrence risk models were applied and assessed.

Results: From 2009 to 2019 12 patients were identified, 8 female and 4 males. Their age at diagnosis ranged from 21 to 76 years. 11 patients underwent surgery with curative intent and no patient suffered disease progression or recurrence, with a mean follow up time of 41 months. One patient presented with metastatic disease and was managed palliatively.

Conclusions: Following this review of our case series and utilising risk recurrence models published in the literature we have changed our follow up protocol. In new cases of SFT the Pasquali prognostic model, with the addition of the presence or absence of necrosis, will be utilised. If a patient has benign features on initial biopsy we propose to not perform staging. Furthermore, if biopsy and final pathology results remain concordant, with no concerning features, and the patient has undergone complete excision reduced intensity follow up could be considered.Level of evidence Level IV, retrospective case series.

Keywords: Musculoskeletal oncology; Sarcoma; Tumours.

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Conflict of interest statement

Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki declaration and it's later amendments or comparable ethical standards. This research was performed at Glasgow Royal Infirmary and the Queen Elizabeth University Hospital.

Figures

Fig. 1
Fig. 1
Coronal and axial pre-operative MRI scan of a patient with a benign SFT of the thigh.
See this image and copyright information in PMC

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