title: A giant solitary fibrous tumor of the mesentery: a case report and literature review.
abstract: We report on an extremely rare case of a giant solitary fibrous tumor (SFT) of the mesentery in a 65-year-old male who was admitted to our hospital because of lower abdominal pain and abdominal fullness. Computed tomography demonstrated a well-defined solid mass of 25 × 11 cm located in the lower abdomen, which was completely resected during surgery. Histopathologically, this lesion had a heterogeneous cell population, mainly comprising spindle cells with fibrous collagen proliferation, and various other cell populations exhibiting patternless growth. Immunohistochemically, the tumor revealed strong and diffuse staining for CD34, bcl-2, and vimentin, and a high mitotic index (seven mitoses per 10 high-power fields). We diagnosed this case as an SFT of the mesentery, which is unusual according to a PubMed search that reported only nine such cases. Our case may be the largest tumor reported to date, and only one retrieved case reported recurrence, although the lesion was exceptionally large with deep invasion. Nonetheless, the lesion in our case was larger than that in the reported case of recurrence and invasive to the ileum. Since surgery, there has been no evidence of recurrence. Hence, we propose that a large SFT and high mitotic index may present risk factors for recurrence. Therefore, long-term careful follow-up is necessary in such cases, although our case exhibited few risk factors for recurrence. A follow-up at 12 months after surgery found no indications of recurrence.
authors: Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. kiyo-n@tokyo-med.ac.jp.
authors: Kiyotaka
authors: K
authors: Nishida
authors: Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. h-ubu@tokyo-med.ac.jp.
authors: Hideyuki
authors: H
authors: Ubukata
authors: Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. konitan@tokyo-med.ac.jp.
authors: Satoru
authors: S
authors: Konishi
authors: Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. shima-j@tokyo-med.ac.jp.
authors: Jiro
authors: J
authors: Shimazaki
authors: Department of Diagnostic Pathology Division, Tokyo Medical University, Ibaraki Medical Center, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. yycluby@gmail.com.
authors: Youko
authors: Y
authors: Yano
authors: Department of Diagnostic Pathology Division, Tokyo Medical University, Ibaraki Medical Center, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. ymorishi@tokyo-med.ac.jp.
authors: Yukio
authors: Y
authors: Morishita
authors: Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1 Chuo Ami, Inashiki, Ibaraki, 300-0395, Japan. tabuchi@tokyo-med.ac.jp.
authors: Takafumi
authors: T
authors: Tabuchi
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008643:Mesentery / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D054364:Solitary Fibrous Tumors / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
references: Radiographics. 2006 Jan-Feb;26(1):245-64
references: 16418255
references: J Pediatr Surg. 2011 Mar;46(3):e5-9
references: 21376187
references: Tumori. 2010 Nov-Dec;96(6):1035-9
references: 21388072
references: Int J Surg Pathol. 2011 Aug;19(4):476-86
references: 21878477
references: J Cancer Res Ther. 2011 Jul-Sep;7(3):376-8
references: 22044832
references: World J Surg Oncol. 2011;9:140
references: 22035205
references: Gastroenterology. 2012 Jan;142(1):12-3, 187-8
references: 22107718
references: Am J Surg Pathol. 2012 Aug;36(8):1202-15
references: 22613995
references: Gan To Kagaku Ryoho. 2013 Nov;40(12):2466-9
references: 24394146
references: G Chir. 2012 Aug-Sep;33(8-9):271-3
references: 23017287
references: Cancer Imaging. 2009;9:67-9
references: 19892620
references: Hum Pathol. 1999 Dec;30(12):1464-73
references: 10667425
references: Hum Pathol. 2002 May;33(5):459-65
references: 12094370
references: Arch Pathol Lab Med. 1990 May;114(5):493-5
references: 2334258
references: Histopathology. 1991 Dec;19(6):515-22
references: 1786936
references: Am J Gastroenterol. 1996 Apr;91(4):810-1
references: 8677962
references: Histopathology. 2006 Jan;48(1):63-74
references: 16359538
references: APMIS. 2008 Nov;116(11):1020-5
references: 19133003