Hepatic solitary fibrous tumour

Hepatic solitary fibrous tumours (hepatic SFTs) are rare mesenchymal tumours.

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).

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.

Microscopic appearance

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

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

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

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 5

Most recorded hepatic SFTs are benign, but it is possible for them to exhibit malignant behaviour 2. Some think that malignant foci may exist in biopsy-benign tumours, and the risk of malignancy is estimated at ~10% 1.

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

Hepatobiliary pathology
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Article information

rID: 34289
Section: Pathology
Synonyms or Alternate Spellings:
  • Solitary fibrous tumour of the liver
  • Solitary hepaitc fibrous tumour
  • Solitary fibrous tumor of the liver
  • Solitary fibrous tumours of the liver
  • Solitary fibrous tumors of the liver

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Cases and figures

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    TR 3.222 / TE 1.1...
    Case 1: axial bSSFP FS
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