A Case of Large Solitary Fibrous Tumor Originated from Retroperitoneum

Takashi Hiromatsu, Masatoshi Akita, Hiroshi Hasegawa, Eiji Sakamoto, Shunichiro Komatsu, Kiyotaka Kawai, Tomotake Tabata, Seiji Natsume, Taro Aoba and Toyonori Tsuzuki*

Department of Surgery and Department of Pathology*, Nagoya Daini Red Cross Hospital

We report a large solitary fibrous tumor (SFT) of the retroperitoneum. A 47-year-old man was admitted to our department complaining of fullness. Physical examination revealed a large mass palpable in the whole abdomen. Abdominal computed tomography (CT) showed a large mass occupying the entire abdominal cavity. Magnetic resonance imaging showed a well-defined tumor of low intensity on T1-weighted images and of high intensity on T2-weighted images. A barium enema showed the compression of the transverse colon by the tumor. Angiography revealed a feeding artery from the left renal artery. We performed a laparotomy based on a diagnosis of a tumor arising from the retroperitoneum. During the operation, the tumor was observed to arise from the retroperitoneum and to extend around the left adrenal gland. The resected specimen was encapsuled elastic hard tumor 395×250×170 mm in size and weighed 7.5 kg. The cut surface of the specimen was grayish-white in color with focal hemorrhages. Histologically, the tumor consisited of spindle cells in a storiform pattern surrounded by abundant patternless collagen. Immunohistochemically, the tumor cells were diffusely positive for CD34, Bcl-2, and MIC-2. Based on these findings, the patient was diagnosed as having a solitary fibrous tumor of the retroperitoneum. This is the largest SFT to be reported. The patient is alive without recurrence 21 months after the operation.

Key words
solitary fibrous tumor, retroperitoneum

Reprint requests
Takashi Hiromatsu Department of Surgery, Nagoya Daini Red Cross Hospital
2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650 JAPAN

Accepted
March 22, 2006

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