Hepatic solitary fibrous tumor
Citation, DOI and article data
Hepatic solitary fibrous tumors (hepatic SFTs) are rare mesenchymal tumors.
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.
These tumors demonstrate high cellular proliferation of spindle cells arranged in a storiform pattern.
- 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. Intratumoral necrosis has been reported in a few lesions. Benign tumors cannot currently be reliably be differentiated from malignant tumors.
- nonspecific enhancing mass
- heterogeneous enhancement has been reported
- T1: hypointense
- T2: heterogeneous appearance
- T1 C+ (Gd): heterogeneous enhancement, depending on the relative amounts of cellular and collagen components
- FDG-PET: avid FDG uptake 5
Treatment and prognosis
Most recorded hepatic SFTs are benign, but it is possible for them to exhibit malignant behavior 2. Some think that malignant foci may exist in biopsy-benign tumors, and the risk of malignancy is estimated at ~10% 1.
Given the rarity of the tumor, no standard treatment exists. Partial hepatectomy has been performed for some lesions, given the concern for occult malignancy.
- 1. Debs T, Kassir R, Amor IB et-al. Solitary fibrous tumor of the liver: report of two cases and review of the literature. Int J Surg. 2014;12 (12): 1291-4. doi:10.1016/j.ijsu.2014.10.037 - Pubmed citation
- 2. Vennarecci G, Ettorre GM, Giovannelli L et-al. Solitary fibrous tumor of the liver. J Hepatobiliary Pancreat Surg. 2005;12 (4): 341-4. doi:10.1007/s00534-005-0993-0 - Pubmed citation
- 3. Liu Q, Liu J, Chen W et-al. Primary solitary fibrous tumors of liver: a case report and literature review. Diagn Pathol. 2013;8 (1): 195. doi:10.1186/1746-1596-8-195 - Free text at pubmed - Pubmed citation
- 4. Fuksbrumer MS, Klimstra D, Panicek DM. Solitary fibrous tumor of the liver: imaging findings. AJR Am J Roentgenol. 2000;175 (6): 1683-7. doi:10.2214/ajr.175.6.1751683 - Pubmed citation
- 5. Song L, Zhang W, Zhang Y. (18)F-FDG PET/CT imaging of malignant hepatic solitary fibrous tumor. Clin Nucl Med. 2014;39 (7): 662-4. doi:10.1097/RLU.0000000000000431 - Pubmed citation