Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4844
Peer-review started: July 16, 2020
First decision: August 21, 2020
Revised: August 23, 2020
Accepted: September 11, 2020
Article in press: September 11, 2020
Published online: October 26, 2020
Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior; it is predominantly benign, and rarely metastasizes. SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax, and can be found throughout the body, though extra-thoracic localization, including the cephalic region, is un-common. We reported the first case of intracranial malignant SFT metastasized to the chest wall.
An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss. His medical history included partial resection due to brain tumor, four times, and 50-Gray radiation therapy at another hospital, starting when he was 74 years old. An unenhanced head computed tomography (CT) scan revealed an 8 cm × 5.1 cm × 6.5 cm mixed-density mass at the left frontal lobe, accompanying a midline shift, and an unenhanced chest-abdomen CT scan revealed a 6 cm × 4.1 cm × 6.5 cm low-density mass in the left chest wall. A CT-guided percutaneous lung biopsy was performed, and the pathological findings were SFT corresponding to brain tumor. Finally, the correct diagnosis of his brain tumor in history of past illness revealed to be SFT, and the unremovable tumor, namely present brain lesions enlarged and metastasized to the chest wall. We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall. We notified him and his family of the disease, and offered palliative care. He passed away on the 29th hospital day.
This case suggests the need for careful, detailed examination, and careful follow-up when encountering patients presenting with a mass.
Core Tip: Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues, demonstrating broad-spectrum biological behavior; it is ordinarily benign, and rarely known to metastasize. SFT occurs primarily in the serosa tissue structure in the pleura and the thorax, and can be found throughout the body, though extra-thoracic localization, including the cephalic region, is uncommon. We have reported the first known case of intracranial malignant SFT metastasized to the chest wall; this case suggests the need for careful, detailed examination, and careful follow-up when encountering patients presenting with a mass.