Solitary fibrous tumor of the liver: a clinicopathologic and immunohistochemical study of nine cases

Our plain-English summary of Solitary fibrous tumor of the liver: a clinicopathologic and immunohistochemical study of nine cases, by C.A. Moran, K.G. Ishak, Z.D. Goodman (Annals of Diagnostic Pathology, 1998).

The study

• Authors: C.A. Moran, K.G. Ishak, Z.D. Goodman
• Journal: Annals of Diagnostic Pathology
• Published: 1998;2(1):19-24
• Cited by: 61 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Nine cases of primary solitary fibrous tumors of the liver are presented. The patients are 7 women and 2 men between the ages of 32 and 83 years (mean, 57.5 years). Clinically, palpable masses were detected during physical examination in five patients. Two patients presented with symptoms of cholecystitis, one with hematuria, one with periumbilical pain, and one with hypoglycemia. One patient was found to have an abdominal mass during follow-up evaluation for colonic carcinoma, whereas in one patient the tumor was an incidental finding at autopsy. Two patients were asymptomatic, and the tumor masses were detected during a routine physical examination. Grossly, the tumors varied in size from 2 to more than 20 cm in greatest dimension and were described as firm, white-to-gray, well or ill defined. Eight tumors were described as intraparenchymal lesions, two were grossly necrotic, and one tumor was attached by a pedicle to the liver capsule without infiltration into the liver parenchyma. Histologically, most of the tumors had a bland appearance with the classic short storiform (so-called patternless) pattern and absence of cellular atypia, mitoses and/or necrosis. However, in two cases, there was marked cellular atypia and mitotic figures varying from 2 to 4 mitoses per 10 high power field (hpf). Immunohistochemically, all the tumors showed a strong positive reaction against antibodies for CD-34 and vimentin. Follow-up information showed that two patients died within days of postsurgical resection of the tumor, whereas one was alive and well 1 year after initial diagnosis. No follow-up information was available for the other five patients. The cases herein presented highlight the ubiquitous distribution of this neoplasm and the similar clinical and histopathological features to those observed in serosal surfaces. Solitary fibrous tumors of the liver, although rare, need to be considered in the differential diagnosis of mesenchymal lesions of the liver.

In plain English

This case series described nine primary solitary fibrous tumors of the liver, drawn from cases held at the Armed Forces Institute of Pathology in Washington, DC. The article also uses the name localized fibrous mesothelioma for this tumor. It did not discuss asbestos or any other exposure. The patients were 7 women and 2 men aged 32 to 83 years (mean 57.5). Their complaints included symptoms of cholecystitis, pain around the navel, low blood sugar (hypoglycemia) and blood in the urine. Two patients had no symptoms, and one tumor was found at autopsy. Tumors measured from 2 to more than 20 cm. Eight grew within the liver, and one was attached to the liver surface by a stalk. Two tumors showed necrosis, marked cell atypia and 2 to 4 mitoses per 10 high-power fields. The text reported that all eight tumors tested stained strongly for CD34 and vimentin, but the table lists one exception for each. Two patients died within days of surgery from surgical complications. One was well after 1 year, and five had no follow-up. The authors concluded that these tumors belong in the differential diagnosis of mesenchymal liver lesions. They noted that follow-up was too short to judge outcome.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series (clinicopathologic and immunohistochemical study) of pathology archive cases
• Who was studied: Nine patients with primary solitary fibrous tumor of the liver (7 women, 2 men, aged 32 to 83, mean 57.5 years), from the Armed Forces Institute of Pathology, Washington, DC; dates not given
• Exposure: No exposure was studied. The article does not mention asbestos or any other exposure; it describes tumor features.
• Main results:
  • Tumors measured from 2 to more than 20 cm in greatest dimension
  • Eight tumors were within the liver tissue, two were grossly necrotic, and one was attached to the liver capsule by a stalk (pedicle) without growing into the liver
  • In two cases there was necrosis, prominent cellular atypia and 2 to 4 mitotic figures per 10 high-power fields; the remaining cases showed none of these
  • Of the eight cases stained, the text reports all were strongly positive for CD34 and vimentin and negative for the other markers tested (the table conflicts; see text problems)
  • One patient had hypoglycemia
  • Two patients died within days of surgery from surgical complications, one was alive and well 1 year after diagnosis, and no information was available for five
• The authors' conclusion: The authors concluded that the cases confirm this tumor can occur in many sites and that it should be included in the differential diagnosis of mesenchymal liver lesions
• Limitations the authors state:
  • Follow-up in these cases, and in published cases, was too short to draw conclusions about the clinical course, especially for the tumors with atypical features

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Solitary Fibrous Tumor, Carcinoma, Autopsy, Parenchyma, Necrosis, Neoplasm, Serosal Surface, Differential Diagnosis.

Related studies

• Giant solitary fibrous tumor of the liver with metastasis to the skeletal system successfully treated with trisegmentectomy — S. Yilmaz, V. Kirimlioglu, et al. (2000)
• Solitary fibrous tumor of the buccal mucosa: report of a case with immunohistochemical studies — S. Iwai, M. Nakazawa, et al. (1999)
• Solitary fibrous tumour of the tongue: a case report with immunohistochemical studies — Y. Yamashita, T. Satoh, et al. (2002)
• Cytopathological features of solitary fibrous tumor of the pleura: a study of 5 cases — B. Weynand, P. Collard, et al. (1998)
• Solitary fibrous tumor of the pleura. An immunohistochemical, electron microscopic and tissue culture study of a tumor producing insulin-like growth factor I in a patient with hypoglycemia — E.H. Strøm, F. Skjørten, et al. (1991)
• Benign tumors of the liver — K.G. Ishak, L. Rabin (1975)

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