Solitary fibrous tumor(SFT) is a mesenchymal tumor typically located in the pleura,but can also be found as an asymptomatic mass in other areas,including the liver,peritoneum,kidney and salivary glands.However,SFT rar...Solitary fibrous tumor(SFT) is a mesenchymal tumor typically located in the pleura,but can also be found as an asymptomatic mass in other areas,including the liver,peritoneum,kidney and salivary glands.However,SFT rarely locates in the pancreas.We present such a case of pancreatic SFT,along with a review of all reported cases.A 55-year-old man was treated surgically for an asymptomatic pancreatic mass after a rigorous preoperative control.Histologic examination of the resected specimen showed characteristics of an SFT.As only 15 cases of pancreatic SFT have been reported so far,an attempt to compare the cases was considered intriguing.We found that patients with pancreatic SFT were mainly women(81.25%),with a median age of 54 years at the time of diagnosis and a median tumor size of 5.83 cm.Pancreatic SFTs were revealed incidentally in 50% of cases,and all of them showed an enhancement through arterial computed tomography.All tumors were positive for CD34,ten were positive for Bcl-2,and twelve were negative for S100.The diagnosis of this pancreatic tumor is established by a combination of clinical suspicion,imaging procedures and histological findings,and is confirmed by immunohistochemical staining.Although the behavior of SFTs is rather benign,close clinical follow-up is recommended due to a potentially malignant nature.展开更多
Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpresse...Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpressed fibroblast growth factor 23 (FGF23) is responsible for the hypophosphatemia and osteomalacia. The tumors associated with TIO are usually phosphaturic mesenchymal tumor mixed connective tissue variants (PMTMCT). Surgical removal of the responsible tumors is clinically essential for the treatment of TIO. However, identifying the responsible tumors is often difficult. Here, we report a case of a TIO patient with elevated serum FGF23 levels suffering from bone pain and hypophosphatemia for more than three years. A tumor was finally located in first metacarpal bone by octreotide scintigraphy and she was cured by surgery. After complete excision of the tumor, serum FGF23 levels rapidly decreased, dropping to 54.7% of the preoperative level one hour after surgery and eventually to a little below normal. The patient's serum phosphate level rapidly improved and returned to normal level in four days. Accordingly, her clinical symptoms were greatly improved within one month after surgery. There was no sign of tumor recurrence during an 18-month period of follow-up. According to pathology, the tumor was originally diagnosed as "glomangioma" based upon a biopsy sample, "proliferative giant cell tumor of tendon sheath" based upon sections of tumor, and finally diagnosed as PMTMCT by consultation one year after surgery. In conclusion, although an extremely rare disease, clinicians and pathologists should be aware of the existence of TIO and PMTMCT, respectively.展开更多
文摘Solitary fibrous tumor(SFT) is a mesenchymal tumor typically located in the pleura,but can also be found as an asymptomatic mass in other areas,including the liver,peritoneum,kidney and salivary glands.However,SFT rarely locates in the pancreas.We present such a case of pancreatic SFT,along with a review of all reported cases.A 55-year-old man was treated surgically for an asymptomatic pancreatic mass after a rigorous preoperative control.Histologic examination of the resected specimen showed characteristics of an SFT.As only 15 cases of pancreatic SFT have been reported so far,an attempt to compare the cases was considered intriguing.We found that patients with pancreatic SFT were mainly women(81.25%),with a median age of 54 years at the time of diagnosis and a median tumor size of 5.83 cm.Pancreatic SFTs were revealed incidentally in 50% of cases,and all of them showed an enhancement through arterial computed tomography.All tumors were positive for CD34,ten were positive for Bcl-2,and twelve were negative for S100.The diagnosis of this pancreatic tumor is established by a combination of clinical suspicion,imaging procedures and histological findings,and is confirmed by immunohistochemical staining.Although the behavior of SFTs is rather benign,close clinical follow-up is recommended due to a potentially malignant nature.
文摘Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpressed fibroblast growth factor 23 (FGF23) is responsible for the hypophosphatemia and osteomalacia. The tumors associated with TIO are usually phosphaturic mesenchymal tumor mixed connective tissue variants (PMTMCT). Surgical removal of the responsible tumors is clinically essential for the treatment of TIO. However, identifying the responsible tumors is often difficult. Here, we report a case of a TIO patient with elevated serum FGF23 levels suffering from bone pain and hypophosphatemia for more than three years. A tumor was finally located in first metacarpal bone by octreotide scintigraphy and she was cured by surgery. After complete excision of the tumor, serum FGF23 levels rapidly decreased, dropping to 54.7% of the preoperative level one hour after surgery and eventually to a little below normal. The patient's serum phosphate level rapidly improved and returned to normal level in four days. Accordingly, her clinical symptoms were greatly improved within one month after surgery. There was no sign of tumor recurrence during an 18-month period of follow-up. According to pathology, the tumor was originally diagnosed as "glomangioma" based upon a biopsy sample, "proliferative giant cell tumor of tendon sheath" based upon sections of tumor, and finally diagnosed as PMTMCT by consultation one year after surgery. In conclusion, although an extremely rare disease, clinicians and pathologists should be aware of the existence of TIO and PMTMCT, respectively.
