Skip to main content

Advertisement

SpringerLink
Log in

Solitary fibrous tumor: an update on the spectrum of extrapleural manifestations

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Solitary fibrous tumor (SFT) is a rare tumor initially believed to be a benign localized pleural tumor of mesothelial origin. Over the past few years, the literature on this tumor has grown tremendously. The tumor is now reported in diverse bodily locations, and recognized to have a wider range of clinical and radiological features. The most common extrapleural sites of the tumor are the orbits and the extremities. Tumors are often well-circumscribed masses, and vary in size from 1 cm to over 30 cm. The admixture of histological components in the tumor, namely, fibrous tissue, cellular components, and highly vascularized areas consisting of numerous closely packed small to medium-sized blood vessels, influence the imaging appearances of the tumor. On magnetic resonance imaging (MRI), the diagnosis of solitary fibrous tumor is suggested by a well-circumscribed mass that has smooth margins, and focal or diffuse hypointense signal on T2-weighted imaging due to fibrous content in the tumor. SFTs demonstrate strong focal or diffuse contrast enhancement due to the highly vascularized areas in the tumor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 6
Fig. 5
Fig. 7

Similar content being viewed by others

References

  1. Klemperer P, Rabin CB. Primary neoplasms of the pleura. A report of five cases. Arch Pathol. 1931;11:385–412.

    Google Scholar 

  2. Chan JK. Solitary fibrous tumour everywhere, and a diagnosis in vogue. Histopathology. 1997;31:568–76.

    Article  PubMed  CAS  Google Scholar 

  3. Flint A, Weiss SW. CD-34 and keratin expression distinguishes solitary fibrous tumour (fibromesothelioma) of pleura from desmoplastic mesothelioma. Human Pathol. 1995;26:428–31.

    Article  CAS  Google Scholar 

  4. Hasegawa T, Hirose T, Seki K, Yang P, Sano T. Solitary fibrous tumor of the soft tissue: an immunohistochemical and ultrastructural study. Am J Clin Pathol. 1996;106:325–31.

    PubMed  CAS  Google Scholar 

  5. Ide F, Obara K, Mishima K, Saito I, Kusama K. Ultrastructural spectrum of solitary fibrous tumor: a unique perivascular tumor with alternative lines of differentiation. Virchows Arch. 2005;446:646–52.

    Article  PubMed  Google Scholar 

  6. Cardillo G, Facciolo F, Cavazzana AO, et al. Localized (solitary) fibrous tumors of the pleura: an analysis of 55 patients. Ann Thorac Surg. 2000;70:1808–12.

    Article  PubMed  CAS  Google Scholar 

  7. De Perrot M, Fischer S, Brundler MA, et al. Solitary fibrous tumors of the pleura. Ann Thorac Surg. 2002;74:285–93.

    Article  PubMed  Google Scholar 

  8. England DM, Hochholzer L, McCarthy MJ. Localized benign and malignant fibrous tumors of the pleura: a clinicopathologic review of 223 cases. Am J Surg Pathol. 1989;13:640–58.

    Article  PubMed  CAS  Google Scholar 

  9. Briselli M, Mark EJ, Dickersin GR. Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature. Cancer. 1981;47:2678–89.

    Article  PubMed  CAS  Google Scholar 

  10. Mitchell JD. Solitary fibrous tumor of the pleura. Semin Thorac Cardiovasc Surg. 2003;15:305–9.

    Article  PubMed  Google Scholar 

  11. Tateishi U, Nishihara H, Morikawa T, et al. Solitary fibrous tumor of the pleura: MR appearance and enhancement pattern. J Comput Assist Tomogr. 2002;26:174–9.

    Article  PubMed  Google Scholar 

  12. Chang Y, Lee Y, Wu C. Thoracic solitary fibrous tumor: clinical and pathological diversity. Lung Cancer. 1999;23:53–60.

    Article  PubMed  CAS  Google Scholar 

  13. Desser TS, Stark P. Pictorial essay: solitary fibrous tumor of the pleura. J Thorac Imaging. 1998;13:27–35.

    Article  PubMed  CAS  Google Scholar 

  14. Chaugle H, Parchment C, Grotte GJ, et al. Hypoglycaemia associated with a solitary fibrous tumour of the pleura. Eur J Cardiothorac Surg. 1999;15:84–6.

    Article  PubMed  CAS  Google Scholar 

  15. Zhang H, Lucas DR, Pass HI, Che M. Disseminated malignant solitary fibrous tumor of the pleura. Pathol Int. 2004;54:111–5.

    Article  PubMed  Google Scholar 

  16. Insabato L, Siano M, Somma A, Gentile R, Santangelo M, Pettinato G. Extrapleural solitary fibrous tumor: a clinicopathologic study of 19 cases. Int J Surg Pathol. 2009;17:250.

    Article  PubMed  CAS  Google Scholar 

  17. Gigantelli JW, Kincaid M, Soparkar C, et al. Orbital solitary fibrous tumor: radiographic and histopathologic correlations. Ophthal Plastic Reconstr Surg. 2001;17:207–14.

    Article  CAS  Google Scholar 

  18. Kim HJ, Kim H-J, Kim YD, et al. Solitary fibrous tumor of the orbit: CT and MR imaging findings. Am J Neuroradiol. 2008;29:857–62.

    Article  PubMed  CAS  Google Scholar 

  19. Meyer D, Riley F. Solitary fibrous tumor of the orbit: a clinicopathologic entity that warrants both a heightened awareness and an atraumatic surgical removal technique. Orbit. 2006;25:45–50.

    Article  PubMed  Google Scholar 

  20. Tam ES, Chen EC, Nijhawan N, Harvey JT, Howarth D, Oestreicher JH. Solitary fibrous tumor of the orbit: a case series. Orbit. 2008;27:426–31.

    Article  PubMed  Google Scholar 

  21. Polito E, Tosi M, Toti P, Schürfeld K, Caporossi A. Orbital solitary fibrous tumor with aggressive behavior. Three cases and review of the literature. Graefes Arch Clin Exp Ophthalmol. 2002;24:570–4.

    Article  Google Scholar 

  22. Krishnakumar S, Subramanian N, Mohan ER, Mahesh L, Biswas J, Rao NA. Solitary fibrous tumor of the orbit: a clinicopathologic study of six cases with review of the literature. Surv Ophthalmol. 2003;48:544–54.

    Article  PubMed  Google Scholar 

  23. Alawi F, Stratton D, Freedman PD. Solitary fibrous tumor of the oral soft tissues: a clinicopathologic and immunohistochemical study of 16 cases. Am J Surg Pathol. 2001;25:900–10.

    Article  PubMed  CAS  Google Scholar 

  24. Suster S, Nascimento AG, Miettinen M, Sickel JZ, Moran CA. Solitary fibrous tumors of soft tissue. A clinicopathologic and immunohistochemical study of 12 cases. Am J Surg Pathol. 1995;19:1257–66.

    Article  PubMed  CAS  Google Scholar 

  25. Shin JH, Sung IY, Suh JH, Yang SO, Jeong YK, Lee JH, et al. Solitary fibrous tumor in the buccal space: MR findings with pathologic correlation. Am J Neuroradiol. 2001;22:1890–2.

    PubMed  CAS  Google Scholar 

  26. Rodriguez I, Ayala E, Caballero C, et al. Solitary fibrous tumor of the thyroid gland report of seven cases. Am J Surg Pathol. 2001;25:1424–8.

    Article  PubMed  CAS  Google Scholar 

  27. Papi G, Corrado S, Uberti ED, Roti E. Solitary fibrous tumor of the thyroid gland. Thyroid. 2007;17:119–26.

    Article  PubMed  Google Scholar 

  28. Alobid I, Bernal-Sprekelsen M, Benitez P, Moragas M, Nadal A. Solitary fibrous tumor of the larynx. Otolaryngol Head Neck Surg. 2005;133:163–5.

    Article  PubMed  Google Scholar 

  29. Dotto JE, Ahrens W, Lesnik DJ, Kowalski D, Sasaki C, Flynn S. Solitary fibrous tumor of the larynx: a case report and review of the literature. Arch Pathol Lab Med. 2006;130:213–6.

    PubMed  Google Scholar 

  30. Fan CY, Van Hemert RL, Thomas JR, Breau RL. Atypical solitary fibrous tumor of the larynx. Otolaryngol Head Neck Surg. 2006;134:880–2.

    Article  PubMed  Google Scholar 

  31. Chang SK, Yoon DY, Choi CS, Yun EJ, Seo YL, Nam ES. CT, MR, and angiography findings of a solitary fibrous tumor of the larynx: a case report. Korean J Radiol. 2008;9:568–71.

    Article  PubMed  Google Scholar 

  32. Shim YS, Choi SJ, Kim HS, Lee JI. Solitary fibrous tumor of the trachea: CT findings with a pathological correlation. Korean J Radiol. 2008;9:286–9.

    Article  PubMed  Google Scholar 

  33. Hori E, Kurimoto M, Fukuda O, Takahashi C, Nagai S, Oya T, et al. Recurrent intracranial solitary fibrous tumor initially diagnosed as hemangiopericytoma. Brain Tumor Pathol. 2007;24:31–4.

    Article  PubMed  Google Scholar 

  34. Munoz E, Prat A, Adamo B, et al. A rare case of malignant solitary fibrous tumor of the spinal cord. Spine. 2008;33:E397–9.

    Article  PubMed  Google Scholar 

  35. Nawashiro H. Intracranial solitary fibrous tumor of the meninges. Hum Pathol. 2000;31:1536.

    Article  PubMed  CAS  Google Scholar 

  36. Gold JS, Antonescu CR, Hajdu C, et al. Clinicopathologic correlates of solitary fibrous tumors. Cancer. 2002;94:1057–68.

    Article  PubMed  Google Scholar 

  37. El-Khouli RH, Geschwind JF, Bluemke DA, Kamel IR. Solitary fibrous tumor of the liver: magnetic resonance imaging evaluation and treatment with transarterial chemoembolization. J Comput Assist Tomogr. 2008;32:769–71.

    Article  PubMed  Google Scholar 

  38. Fuksbrumer MS, Klimstra D, Panicek DM. Solitary fibrous tumor of the liver: imaging findings. Am J Rev. 2000;175:1683–7.

    CAS  Google Scholar 

  39. Changku J, Shaohua S, Zhicheng Z, Shusen Z. Solitary fibrous tumor of the liver: retrospective study of reported cases. Cancer Investig. 2006;24:132–5.

    Article  Google Scholar 

  40. Moser T, Nogueira T, Neuville A, et al. Delayed enhancement pattern in a localized fibrous tumor of the liver. Am J Rev. 2005;184:1578–80.

    Google Scholar 

  41. Kwon HJ, Byun JH, Kang J, Park SH, Lee MG. Solitary fibrous tumor of the pancreas: imaging findings. Korean J Radiol. 2008;9:S48–51.

    Article  PubMed  Google Scholar 

  42. Prévot S, Penna C, Imbert JC, Wendum D, de Saint-Maur PP. Solitary fibrous tumor of the adrenal gland. Mod Pathol. 1996;9:1170–4.

    PubMed  Google Scholar 

  43. Fine SW, McCarthy DM, Chan TY, Epstein JI, Argani P. Malignant solitary fibrous tumor of the kidney: report of a case and comprehensive review of the literature. Arch Pathol Lab Med. 2006;130:857–61.

    PubMed  Google Scholar 

  44. MacLennan GT, Cheng L. Solitary fibrous tumor of the kidney. J Urol. 2009;181:2731–2.

    Article  PubMed  Google Scholar 

  45. Wang J, Arber DA, Frankel K, Weiss LM. Large solitary fibrous tumor of the kidney: report of two cases and review of the literature. Am J Surg Pathol. 2001;25:1194–9.

    Article  PubMed  CAS  Google Scholar 

  46. Biedrzycki OJ, Singh N, Habeeb H, Wathen N, Faruqi A. Solitary fibrous tumor of the female genital tract a case report and review of the literature. Int J Gynecol Pathol. 2007;26:259–64.

    Article  PubMed  Google Scholar 

  47. Herawi M, Epstein JI. Solitary fibrous tumor on needle biopsy and transurethral resection of the prostate: a clinicopathologic study of 13 cases. Am J Surg Pathol. 2007;31:870–6.

    Article  PubMed  Google Scholar 

  48. Kawamura S, Nakamura T, Oya T, et al. Advanced malignant solitary fibrous tumor in pelvis responding to radiation therapy. Pathol Int. 2007;57:213–8.

    Article  PubMed  Google Scholar 

  49. Wat SY, Sur M, Dhamanaskar K. Solitary fibrous tumor (SFT) of the pelvis. Clin Imaging. 2008;32:152–6.

    Article  PubMed  Google Scholar 

  50. Ito H, Fukuda M, Imamura Y, Fuse H. A malignant solitary fibrous tumor in the retroperitoneum. Int J Clin Oncol. 2008;13:173–5.

    Article  PubMed  Google Scholar 

  51. Shin SS, Jeong YY, Kang HK. Myxoid solitary fibrous tumor of the retroperitoneum: MRI findings with the pathologic correlation. Korean J Radiol. 2008;9:279–82.

    Article  PubMed  Google Scholar 

  52. Takizawa I, Saito T, Kitamura Y, Arai K, Kawaguchi M, Takahashi K, et al. Primary solitary fibrous tumor (SFT) in the retroperitoneum. Urol Oncol. 2008;26:254–9.

    Article  PubMed  Google Scholar 

  53. Tanaka M, Sawai H, Okada Y, Yamamoto M, Funahashi H, Hayakawa T, et al. Malignant solitary fibrous tumor originating from the peritoneum and review of the literature. Med Sci Monit. 2006;12:CS95–8.

    PubMed  Google Scholar 

  54. Magro G, Bisceglia M, Michal M, Eusebi V. Spindle cell lipoma-like tumor, solitary fibrous tumor and myofibroblastoma of the breast: a clinico-pathological analysis of 13 cases in favor of a unifying histogenetic concept. Virchows Arch. 2002;440:249–60.

    Article  PubMed  Google Scholar 

  55. Daigeler A, Lehnhardt M, Langer S, et al. Clinicopathological findings in a case series of extrathoracic solitary fibrous tumors of soft tissues. BMC Surg. 2006;6:10.

    Article  PubMed  Google Scholar 

  56. Akisue T, Matsumoto K, Kizaki T, et al. Solitary fibrous tumor in the extremity: case report and review of the literature. Clin Orthop Relat Res. 2003;411:236–44.

    Article  PubMed  Google Scholar 

  57. Abe S, Imamura T, Tateishi A, et al. Intramuscular solitary fibrous tumor: a clinicopathological case study. J Comput Assist Tomogr. 1999;23:458–62.

    Article  PubMed  CAS  Google Scholar 

  58. Yamaga K, Minamizaki T. Solitary fibrous tumor of the thigh: a patient report. Yonago Acta Med. 2008;51:77–82.

    Google Scholar 

  59. Anders JO, Aurich M, Lang T, Wagner A. Solitary fibrous tumor in the thigh: review of the literature. J Cancer Res Clin Oncol. 2006;132:69–75.

    Article  PubMed  CAS  Google Scholar 

  60. Morimitsu Y, Nakajima M, Hisaoka M, Hashimoto H. Extrapleural solitary fibrous tumor: clinicopathologic study of 17 cases and molecular analysis of the p53 pathway. APMIS. 2000;108:617–25.

    Article  PubMed  CAS  Google Scholar 

  61. Vallat-Decouvelaere AV, Dry SM, Fletcher CDM. Atypical and malignant solitary fibrous tumors in extrathoracic locations: evidence of their comparability to intra-thoracic tumors. Am J Pathol. 1998;22:1501–11.

    Article  CAS  Google Scholar 

  62. O'Connel JX, Logan PM, Beauchamp CP. Solitary fibrous tumors of the periosteum. Hum Pathol. 1995;26:460–2.

    Article  Google Scholar 

  63. Gengler C, Guillou L. Solitary fibrous tumour and haemangiopericytoma: evolution of a concept. Histopathology. 2006;48:63–74.

    Article  PubMed  CAS  Google Scholar 

  64. Park MS, Araujo DM. New insights into the hemangiopericytoma/solitary fibrous tumor spectrum of tumors. Curr Opin Oncol. 2009;21:327–31.

    Article  PubMed  Google Scholar 

  65. Ceballos K, Munk PL, Masri BA, O'Connell JX. Lipomatous hemangiopericytoma. A morphologically distinct soft tissue tumor. Arch Pathol Lab Med. 1999;123:941–5.

    PubMed  CAS  Google Scholar 

  66. Guillou L, Gebhard S, Coindre JM. Lipomatous hemangiopericytoma: a fat-containing variant of solitary fibrous tumor? Clinicopathologic, immunohistochemical, and ultrastructural analysis of a series in favor of a unifying concept. Hum Pathol. 2000;31(9):1108–15.

    Article  PubMed  CAS  Google Scholar 

  67. Yokoi T, Tsuzuki T, Yatabe Y, et al. Solitary fibrous tumor: significance of p53 and CD34 immunoreactivity in its malignant transformation. Histopathology. 1998;32:423–32.

    Article  PubMed  CAS  Google Scholar 

  68. Hara M, Kume M, Oshima H, et al. F-18 FDG uptake in a malignant localized fibrous tumor of the pleura. J Thorac Imaging. 2005;20:118–9.

    Article  PubMed  Google Scholar 

  69. Kramer H, Pieterman RM, Slebos DJ, et al. PET for the evaluation of pleural thickening observed on CT. J Nucl Med. 2004;45:995–8.

    PubMed  Google Scholar 

  70. Hayashi S, Kurihara H, Hirato J, Sasaki T. Solitary fibrous tumor of the orbit with extraorbital extension: case report. Neurosurgery. 2001;49:1241–5.

    PubMed  CAS  Google Scholar 

  71. Migita K, Watanabe A, Nakagawa K, Ohyama T, Sekigawa S. Solitary fibrous tumor of the abdominal wall. Int J Clin Oncol. 2009;14:555–9.

    Article  PubMed  Google Scholar 

  72. Makino H, Miyashita M, Nomura T, et al. Solitary fibrous tumor of the cervical esophagus. Dig Dis Sci. 2007;52:2195–200.

    Article  PubMed  Google Scholar 

  73. Guillou L, Gebhard S, Coindre JM. Orbital and extraorbital giant cell angiofibroma: a giant cell-rich variant of solitary fibrous tumor? Clinicopathologic and immunohistochemical analysis of a series in favor of a unifying concept. Am J Surg Pathol. 2000;24:971–9.

    Article  PubMed  CAS  Google Scholar 

  74. Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. From the archives of the AFIP: imaging of musculoskeletal neurogenic tumors— radiologic–pathologic correlation. Radiographics. 1999;19:1253–80.

    PubMed  CAS  Google Scholar 

Download references

Acknowledgement

The authors thank Robert Turcotte, M.D. for his help in preparing this manuscript.

Author information

Authors and Affiliations

  1. Department of Radiology, McGill University Health Centre, Montreal General Hospital, 1650 Avenue Cedar, C5-118, Montréal, Québec, H3G 1A4, Canada

    Francis N. Musyoki & Thomas I. Powell

  2. Department of Pathology, McGill University Health Centre, Montreal General Hospital, 1650 Avenue Cedar, D3-257, Montréal, Québec, H3G 1A4, Canada

    Ayoub Nahal

Authors
  1. Francis N. Musyoki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayoub Nahal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas I. Powell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francis N. Musyoki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Musyoki, F.N., Nahal, A. & Powell, T.I. Solitary fibrous tumor: an update on the spectrum of extrapleural manifestations. Skeletal Radiol 41, 5–13 (2012). https://doi.org/10.1007/s00256-010-1032-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-010-1032-z

Keywords

Search

Navigation