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Case Reports
. 2023 Feb 9:2023:2271690.
doi: 10.1155/2023/2271690. eCollection 2023.

A Case of Hepatic Malignant Solitary Fibrous Tumor: A Case Report and Review of the Literature

Zhiyan Fu  1 , Evita B Henderson-Jackson  1 , Barbara A Centeno  1 , Gregory Y Lauwers  1 , Mihaela Druta  2 , Daniel A Anaya  3 , Yukihiro Nakanishi  1
Affiliations
Case Reports

A Case of Hepatic Malignant Solitary Fibrous Tumor: A Case Report and Review of the Literature

Zhiyan Fu et al. Case Rep Pathol. .

Abstract

A 73-year-old man with a history of atrial myxoma and basal cell carcinoma presented with unexplained fever. Contrast-enhanced CT abdomen showed a large left hepatic lobe mass with early enhancement and delayed venous washout, concerning for hepatocellular carcinoma. Fine needle aspiration showed numerous spindle cells with malignant nuclear features, suggestive of malignant spindle cell neoplasm. The patient underwent left hepatectomy. The surgical specimen showed a well-circumscribe solid mass (14.6 × 13.0 × 10.0 cm) with necrosis. Histopathological examination revealed a proliferation of spindle tumor cells with characteristic staghorn-shaped blood vessels, frequent mitoses, and necrosis. The tumor cells showed strong and diffuse expression of CD34 and STAT6, confirming the diagnosis of malignant solitary fibrous tumor. Solitary fibrous tumor is a rare fibroblastic tumor characterized by a staghorn vasculature and NAB2-STAT6 gene rearrangement. Solitary fibrous tumor of the liver is a rare occurrence. Although most solitary fibrous tumors behave in a benign fashion, solitary fibrous tumors might act aggressively. This case is unique in that it demonstrates an excellent correlation between radiologic, macroscopic, and microscopic features which can contribute to the improvement of radiologic and pathologic diagnostic accuracy.

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Conflict of interest statement

The authors declare that they have no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
Contrast-enhanced abdominal computed tomography (CT) showed a large well-circumscribed mass in the lateral segment of the left hepatic lobe with early arterial phase enhancement.
Figure 2
Figure 2
The surgical specimen showed a well-circumscribe solid mass (14.6 × 13.0 × 10.0 cm) with central necrosis.
Figure 3
Figure 3
(a, b) The tumor was composed of haphazardly arranged spindle to ovoid cells with indistinct, pale cytoplasm, dense hyalinized collagenous stroma, frequent mitoses, necrosis, and characteristic staghorn-shaped blood vessels ((a) (40x) and (b) (400x)).
Figure 4
Figure 4
(a, b) The tumor cells showed strong and diffuse expression of CD34 ((a) 100x) and STAT6 ((b) 100x).
See this image and copyright information in PMC

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