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SOLITARY FIBROUS TUMOR OF THE ANTERIOR MEDIASTINUM: A RARE EXTRAPLEURAL NEOPLASM

Abstract

Solitary fibrous tumors are uncommon spindle cell neoplasms originally thought to be restricted to the pleura. We describe a 62-year-old woman who presented with stridor and an anterior mediastinal mass. At thoracotomy, a 10.5 × 6.5 × 5.5 cm, circumscribed, firm mediastinal mass demonstrated no direct cardiac or pulmonary involvement. The tumor consisted of spindle cells organized in a patternless pattern with collagenous stroma and hemangiopericytoma-like vessels. Spindle cells were immunoreactive for CD34, CD99, desmin, vimentin and bcl-2 protein and a diagnosis of mediastinal solitary fibrous tumor was confirmed. The differential diagnosis of mediastinal solitary fibrous tumors is extensive and includes spindle cell thymoma, sarcomatoid carcinoma, malignant mesothelioma, inflammatory myofibroblastic tumor, peripheral nerve sheath tumors and various sarcomas. Despite their rarity in the mediastinum, solitary fibrous tumors can be recognized by their classic patternless morphology and immunophenotypic pattern. Their accurate classification is important, as solitary fibrous tumors are intermediate (rarely metastasizing) neoplasms that require complete surgical excision and long-term clinical follow-up for optimum therapy.

Tumori 2007; 93(5): 508 - 510

Article Type: CASE REPORT

Authors

Brian R Gannon, Carolyn D O’Hara, Kenneth Reid, Phillip A Isotalo

Article History

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Authors

  • Gannon, Brian R [PubMed] [Google Scholar]
    Departments of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada
  • O’Hara, Carolyn D [PubMed] [Google Scholar]
    Department of Laboratory Medicine and Pathology, Dynacare Kasper Medical Laboratories and University of Alberta, Edmonton, Alberta, Canada
  • Reid, Kenneth [PubMed] [Google Scholar]
    Surgery, Queen’s University, Kingston, Ontario, Canada
  • Isotalo, Phillip A [PubMed] [Google Scholar]
    Departments of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada

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