Solitary Fibrous Tumor Treated with Laparoscopic Surgery: Case Report and Review of the Literature

Abstract

Abstract

Background: Solitary fibrous tumor is a rare disease in the abdomen with an uncertain outcome. This article reports a case treated with laparoscopic surgery and discusses the caveats that arise in managing such disease with a mini-invasive technique. Case: A 49-year-old woman presented with a pelvic mass. The mass was classified as an ovarian mass with features of malignancy. The possibility of a uterine fibroid was excluded because the mass was moveable. The right ovary was not clearly separated from this mass. This patient was scheduled for immediate laparoscopic adnexectomy and frozen section of the ovarian mass. Although the patient's Ca-125 was negative, the differential diagnosis in the work-up prior to performing the procedure were sarcoma, lymphoma, or metastatic tumor, even if adenocarcinoma could not be excluded. However, a chest x-ray and mammography showed no lesions in the lung or breasts. The patient underwent the procedure and histology testing. The diagnosis at histology was malignant SFT. After consulting with other oncologists, the current authors did not perform a second-look laparoscopy. Results: The patient had no evidence of disease at a 1-year follow-up. Conclusions: Extrathoracic SFTs should be considered in the differential diagnosis of solid pelvic masses with atypical ultrasound features. Surgical removal is the treatment of choice for these tumors and laparoscopy may be accomplished safely. Careful, long-term clinical follow-up is required for all SFTs because of the possibility of late recurrence or metastasis, especially in patients with atypical pathologic findings or positive margins. (J GYNECOL SURG 30:353)