Hepatic solitary fibrous tumor

Solitary
fibrous tumour of the liver—report on metastasis and local recurrence of a malignant case and review of literature. Abdominal CT displaying the pedunculated liver lesion arising from segment IV
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Solitary
fibrous tumour of the liver—report on metastasis and local recurrence of a malignant case and review of literature. Abdominal MRI displaying the liver lesion. a T2WI. b T1WI
wjso.biomedcentral.com • CC-by-4.0
Solitary
fibrous tumour of the liver—report on metastasis and local recurrence of a malignant case and review of literature. MRI T1WI after contrast. a Arterial phase. b Portal venous phase. c Delayed 2 min. d Delayed 10 min
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Solitary
fibrous tumour of the liver—report on metastasis and local recurrence of a malignant case and review of literature. CT abdomen of recurrent disease adjacent to resection site. a–b Axial views. c–d Transverse views
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Solitary
fibrous tumor in the liver: case report and literature review. Contrast-enhanced abdominal computed tomography (CT). Plain CT shows a well-defined low-density mass occupying the right lobe (14.0 cm diameter) (a). Contrast-enhanced CT shows heterogeneous enhancement in the peripheral mass during the arterial phase (b). Enhancement is then centripetal and more pronounced during the portal phase (c) and finally progresses to persistent, less heterogeneous enhancement during the delayed phase (d)
surgicalcasereports.springeropen.com • CC-by-4.0
Solitary
fibrous tumor in the liver: case report and literature review. Magnetic resonance imaging (MRI) and [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET). Abdominal MRI shows low intensity on a T1-weighted image (a) and heterogeneously high or iso intensity on a T2-weighted image (b). Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI reveals a hypointense mass during the hepatobiliary phase (c). Diffusion-weighted imaging shows higher intensity than for normal liver parenchyma (d) with a high b value of 1000 (e). FDG-PET shows no accumulation of [18F]-FDG (f)
surgicalcasereports.springeropen.com • CC-by-4.0
Solitary
fibrous tumor of the liver: a case report. Single mass in the left hepatic lobe. (A) CT scan demonstrated a mass (9.0 × 6.2cm) in left hepatic lobe. (B) and (C) Contrast enhancement in arterial and portal phases was found in the mass. (D) Grossly, a large, gray-white, lobulated, well-circumscribed, partially encapsulated mass was removed after hepatoectomy.
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Giant
solitary fibrous tumour of the liver. CT-scan of the liver preoperative.
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Skull base
metastases from a malignant solitary fibrous tumor of the liver. A case report and literature review. Enhanced CT scan before hepatectomy. A: Arterial phase image showing a large, heterogeneous mass of the liver with hypodense areas, which had clear border between tumor and the normal liver. Lesion showed heterogeneous enhancement and the high density of tumor blood vessels was seen in this region, lower density area to the central region as the center radial arrangement. Left hepatic vein was be compressed by the tumour and turned out to be rigidity. B: Venous late phase images showing a large, solid mass of the liver. Large hypodense tumor of the right hepatic lobe with an enhancement of the peripheral portion. The tumour was diffuse enhanced with a lager hypodense area in the center thought to be necrosis.
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Hepatic solitary fibrous tumors (hepatic SFTs) are rare mesenchymal tumors.

Epidemiology

Fewer than 60 cases have been reported in the literature. Female predominance (~70%). There is a mean age of 52 years at presentation, but a wide range of incidence (16-84 years).

Clinical presentation

If the patient is symptomatic at all, the presentation is usually mild and nonspecific, including abdominal pain, bloating, dyspepsia.

Hypoglycemia has been reported in some patients, presumably a paraneoplastic syndrome.

Pathology

Microscopic appearance

These tumors demonstrate high cellular proliferation of spindle cells arranged in a storiform pattern.

Immunophenotype
  • CD34: positive
  • vimentin: positive
  • Bcl-2: positive
  • SM-actin: negative

Radiographic features

A prospective diagnosis of hepatic SFT is not usually possible because imaging features are usually relatively nonspecific. Intratumoral necrosis has been reported in a few lesions. Benign tumors cannot currently be reliably be differentiated from malignant tumors.

CT
  • nonspecific enhancing mass
    • heterogeneous enhancement has been reported
MRI
  • T1: hypointense
  • T2: heterogeneous appearance
  • T1 C+ (Gd): heterogeneous enhancement, depending on the relative amounts of cellular and collagen components
Nuclear Medicine
  • FDG-PET: avid FDG uptake

Treatment and prognosis

Most recorded hepatic SFTs are benign, but it is possible for them to exhibit malignant behavior . Some think that malignant foci may exist in biopsy-benign tumors, and the risk of malignancy is estimated at ~10% .

Given the rarity of the tumor, no standard treatment exists. Partial hepatectomy has been performed for some lesions, given the concern for occult malignancy.

Differential diagnosis

Siehe auch:
Assoziationen und Differentialdiagnosen zu solitärer fibröser Tumor der Leber:
solitärer
fibröser Tumor
Wikipedia • CC BY-SA 4.0
seltene
Lebertumoren
www.eurorad.org • CC by-nc-sa-4.0