Solitary fibrous tumor arising in the mesentery: a case report
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Solitary fibrous tumor arising in the mesentery: a case report Sarah Bouhabel1, Guy Leblanc1, Jose Ferreira2, Yves E Leclerc1, Pierre Dubé1 and Lucas Sidéris1*
Abstract Background: Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm usually found in the pleura, soft tissues and visceral organs. We describe one case arising in the mesentery, which is an exceptional localization. Case presentation: A 71-year-old man was referred to our establishment for a painless hypogastric mass. Further investigation revealed a vascular tumor, which was resected en bloc. Pathological findings confirmed solitary fibrous tumor of the mesentery. Conclusion: This is the second case of solitary fibrous tumor of the small intestine mesentery ever reported. It was managed by en bloc resection and close follow up considering the high risk of recurrence. Investigation should be made regarding the use of adjuvant systemic therapy to improve long-term survival for these patients.
Background Solitary fibrous tumor is a rare mesenchymal neoplasm first described in the pleura, in 1870, by Wagner [1]. Postulated cells of origin comprise fibroblasts, myofibroblasts endothelial cells, as well as pericytes [2]. It usually arises in the pleura, pericardium, soft tissues and visceral organs [2]. We report a case with an unusual localization in the mesentery. To our knowledge, this case would be the second reported case arising in the small intestine mesentery [3-7]. Case presentation A 71-year-old man was referred to the medical oncology department for the incidental finding of a palpable hypogastric mass. The patient did not complain of abdominal pain or any other gastrointestinal symptoms. He was in good general condition, with no relevant past medical history, except for a right total hip replacement that the patient underwent 10 years previously. A percutaneous biopsy was initially done to rule out a possible lymphoma. The pathology results were however consistent with a hemangiopericytoma or a solitary fibrous tumor. The patient was then referred to our surgical oncology department for resection. Abdominal CT scan
with contrast revealed a fibrous tumor at the root of the mesentery, surrounding the superior mesenteric vein. There was neither thrombosis, nor hepatic or lymphatic involvement and the tumor seemed resectable. On March 12th 2010, the patient underwent surgery with complete resection of the mesenteric tumor as well as 22 cm of small intestine (Figure 1). The patient had an uneventful recovery and was discharged 6 days after surgery. Gross pathologic examination revealed a 15,5 × 14 × 9 cm multinodular lesion. It was solid, pink-to-gray shaded and well vascularised without any macroscopic necrosis. It had no attachment to the intestinal wall, and presented an infiltrative pattern at the root of the mesentery. The small intestine portion was normal and the margins were clear. The specimen was submitted for histopathologic study, which was in favor of a malignant sol
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