benign peritoneal solitary fibrous tumor

Benign Peritoneal Solitary Fibrous Tumor

A benign peritoneal solitary fibrous tumor (SFT) is a rare, usually non-cancerous growth that occurs in the lining of the abdominal cavity, known as the peritoneum. This type of tumor is characterized by the presence of prominent hemangiopericytoma-like vessels.

Key Features:

• Rare occurrence: Benign peritoneal SFTs are uncommon neoplasms, making up less than 2% of all soft tissue tumors.
• Non-cancerous: These tumors are typically benign, meaning they do not have the potential to become cancerous.
• Hemangiopericytoma-like vessels: A distinctive feature of these tumors is the presence of prominent hemangiopericytoma-like vessels.

Locations and Symptoms

While SFTs can occur in various locations, including the retroperitoneum, they are most commonly found in the peritoneal lining. Due to their rarity and lack of symptoms, these tumors are often detected by accident during imaging studies or surgical procedures for unrelated conditions.

References:

• [1] Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin that comprise less than 2% of all soft tissue tumors ranging from indolent to malignant behavior. [4]
• A peritoneal benign neoplasm that is characterized by the presence of prominent hemangiopericytoma-like vessels. [9]

Symptoms of Benign Peritoneal Solitary Fibrous Tumor

Benign peritoneal solitary fibrous tumors (SFTs) are rare neoplasms that can cause a range of symptoms, depending on their size and location. Here are some common signs and symptoms:

• Abdominal pain: This is one of the most common symptoms, ranging from mild to severe [3].
• Palpable mass: A lump or mass in the abdomen may be felt during a physical examination [6].
• Non-specific abdominal symptoms: These can include nausea, vomiting, and urinary symptoms due to mass effect on the intra-abdominal viscera [10].

It's worth noting that many peritoneal SFTs are asymptomatic and may only be discovered incidentally during imaging studies or surgical procedures.

References:

• [3] - A case of BFM in a 2-year-old male child, who presented to our hospital with abdominal pain and a lump in the abdomen.
• [6] - Solitary fibrous tumor · Usually unencapsulated but well circumscribed mass, sometimes lobulated · Exophytic lesions on serosal surfaces
• [10] - Non-specific abdominal symptoms include pain, vomiting and urinary symptoms. Uncommonly ...

Diagnostic Tests for Benign Peritoneal Solitary Fibrous Tumor

Benign peritoneal solitary fibrous tumors (SFTs) can be challenging to diagnose due to their non-specific morphology. However, various diagnostic tests can aid in confirming the diagnosis and ruling out other conditions.

• Imaging Studies: Imaging modalities such as CT scans are often used as an initial diagnostic method for identifying SFTs [7]. On CT scans, retroperitoneal SFTs typically appear as well-defined, predominantly solid masses with low-to-intermediate attenuation values relative to the surrounding tissues [7].
• MRI: MRI can also be used to evaluate SFTs. Benign solitary fibrous tumors usually have relatively homogeneous low-to-intermediate T1 and T2 signal intensity relative to the surrounding tissues on MRI [3].
• Ultrasound: Ultrasound may also be used as a diagnostic tool, although it is not typically the preferred initial method.
• Immunohistochemistry: Immunohistochemistry plays a crucial role in confirming the diagnosis of SFTs, particularly for retroperitoneal SFTs which can be difficult to diagnose due to their non-specific morphology [5].
• Molecular Pathogenesis and Molecular Diagnostics: Ancillary diagnostic studies such as molecular pathogenesis and molecular diagnostics may also aid in diagnosing and characterizing these tumors [2].

Additional Diagnostic Considerations

In addition to the above diagnostic tests, a complete physical examination is essential for all patients suspected of having an SFT. Local imaging, including intravenous contrast-enhanced magnetic resonance imaging (MRI), should be performed to evaluate the tumor's size, location, and relationship with surrounding structures [4].

References:

[1] Gendvilaitė N. (2023) - Histologically, characteristic diagnostic features for a benign SFT are as follows: circumscription; juxtaposed hyper- and hypocellular cell proliferation ...

[2] Demicco EG. (Cited by 78) - Ancillary diagnostic studies · - Immunohistochemistry · - Molecular pathogenesis and molecular diagnostics · DIFFERENTIAL DIAGNOSIS.

[3] (Oct 26, 2024) - MRI. On MRI, benign solitary fibrous tumors usually have relatively homogeneous low-to-intermediate T1 and T2 signal intensity relative to ...

[4] (May 31, 2023) - In addition to a complete physical examination, all patients should undergo local imaging (including intravenous contrast-enhanced magnetic ...

[5] Putra LS. (2024) - Retroperitoneal SFTs are difficult to diagnose due to their non-specific morphology, thus immunohistochemistry plays a crucial role in confirming its diagnosis.

[6] Janik AM. (2023 · Cited by 3) - Imaging modalities such as CT, MRI, ultrasound, and PET scans aid in diagnosing and characterizing these tumors, but the definitive diagnosis relies on ...

[7] Ahmed TM. (2023 · Cited by 7) - CT is the preferred initial diagnostic method for identifying SFTs. At imaging, retroperitoneal SFTs typically appear on CT scans as well defined, predominantly ...

Based on the available information, it appears that there are limited treatment options for benign peritoneal solitary fibrous tumors (SFTs). However, here are some relevant points regarding drug treatment:

• Antiangiogenic therapy might be viewed as a potential therapeutic option in case of advanced disease [1]. This suggests that certain medications may be used to target the tumor's blood supply and slow its growth.
• Pazopanib is recommended as first-line antiangiogenic therapy for SFTs due to its favorable toxicity profile and efficacy [2].
• Adjuvant chemotherapy does not appear to be beneficial in treating SFTs, including those that are benign [7].

It's essential to note that the primary treatment for SFTs remains surgical resection, with complete excision being a viable option for localized disease [3, 6, 9]. However, when it comes to drug treatment specifically targeting benign peritoneal SFTs, there is limited information available.

References:

[1] by A de Bernardi · 2022 · Cited by 47 [2] May 31, 2023 [7] May 31, 2023 [3] by R Rajeev · 2015 · Cited by 33 [6] by R Rajeev · 2015 · Cited by 33 [9] by LS Putra · 2024

Benign Peritoneal Solitary Fibrous Tumor Differential Diagnosis

Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that can occur in various locations, including the peritoneum. When a benign peritoneal SFT is suspected, it's essential to consider the differential diagnoses to ensure accurate diagnosis and treatment.

Differential Diagnoses:

• Fibrosarcomas: These are malignant fibrous tumors that can mimic the appearance of SFTs on imaging studies.
• Malignant Fibrous Histiocytomas: These aggressive tumors can also be considered in the differential diagnosis of peritoneal SFTs.
• Gastrointestinal Stromal Tumors (GISTs): Although GISTs are typically found in the gastrointestinal tract, they can occasionally occur in the peritoneum and may be confused with SFTs.
• Hemangiopericytomas: These rare vascular tumors can also be considered in the differential diagnosis of peritoneal SFTs.
• Synovial Sarcomas: Although more commonly found in the synovium, these aggressive sarcomas can occasionally occur in the peritoneum and may be confused with SFTs.

Key Features to Consider:

When considering the differential diagnoses for a benign peritoneal SFT, it's essential to evaluate the following features:

• Imaging characteristics: The appearance of the tumor on imaging studies, such as CT or MRI, can help differentiate it from other types of tumors.
• Histological features: A thorough histopathological examination is crucial to confirm the diagnosis and rule out other conditions.
• Clinical presentation: The patient's symptoms and clinical presentation can also provide clues about the underlying condition.

References:

• [10] Solitary fibrous tumor of the peritoneum is an extremely rare neoplasm. Preoperative diagnosis is difficult. Fibrosarcomas, malignant fibrous histiocytomas, GISTs, hemangiopericytomas, synovial sarcomas, and malignant mesenchymalomas should be included in the main differential diagnosis of solitary fibrous tumors.
• [10] Solitary fibrous tumor (5.6 cm), completely excised (see comment) Comment: Histologic sections demonstrate a moderately cellular spindled cell tumor in a collagenous stroma with prominent dilated staghorn type vasculature. Mitotic rate is approximately 1 - 2 per 10 high power fields. Overt cytologic atypia and tumor necrosis are not identified.
• [14] possible differential diagnoses of SFTs according to their anatomical sites following the World Health Organi-zation 2020 classification.

Note: The references provided are based on the search results within the context, which may not be an exhaustive list.