Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: A case report and review of literature

Abstract

Background: A solitary fibrous tumor (SFT) is often located in the pleura, while SFT of the pancreas is extremely rare. Here, we report a case of SFT of the pancreas and discuss imaging, histopathology, and immunohistochemistry for accurate diagnosis and treatment.

Case summary: A 54-year-old man presented to our hospital with pancreatic occupancy for over a month. There were no previous complaints of discomfort. His blood pressure was normal. Blood glucose, tumor markers, and enhanced computed tomography (CT) suggested a malignant tumor. Because the CT appearance of pancreatic cancer varies, we could not confirm the diagnosis; therefore, we performed endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). Pathology and immunohistochemistry were consistent with SFT of the pancreas. The postoperative pathology and immunohistochemistry were consistent with the puncture results. The patient presented for a follow-up examination one month after discharge with no adverse effects.

Conclusion: Other diseases must be excluded in patients with a pancreatic mass that cannot be diagnosed. CT and pathological histology have diagnostic value for pancreatic tumors. Endoscopic puncture biopsy under ultrasound can help diagnose pancreatic masses that cannot be diagnosed preoperatively. Surgery is an effective treatment for SFT of the pancreas; however, long-term follow-up is strongly recommended because of the possibility of malignant transformation of the tumor.

Keywords: Case report; Endoscopic ultrasound-guided fine-needle biopsy; Neoplasm fibrous tumor; Pancreas; Treatment.

Figure 1

Abdominal computed tomography scan showing a 5.52 cm × 2.82 cm × 2 cm mass in the pancreas (orange arrows). A: No enhancement in the arterial region. B: Heterogeneous enhancement in the venous area.

Figure 2

Postoperative surgical specimen: Pancreatic tail and spleen (tumor cut open chart) (orange arrows).

Figure 3

Representative results of hematoxylin and eosin and immunohistochemical staining of surgical specimens of solitary fibrous tumor of the pancreas. A: Hematoxylin and Eosin staining (hematoxylin and Shuhong); B: Immunohistochemistry (original magnifcation of × 400) signal transducer and activator of transcription 6; C: CD34; D: CD99; E: Vimentin; F: Vimentin; G: Ki-67.