Multidetector CT and Magnetic Resonance Imaging Features of Solitary Fibrous Tumors in the Pelvis and the Relevant Pathologic Basis Changes_Journal of Biomedical Engineering

Authors：

LIXueming ¹ , RENJing ¹ , ZHOUPeng ¹ , CAOYing ¹ , CHENGZhuzhong ¹ , YUJianqun ² ,  XUGuohui ¹

1. Department of Radiology, Sichuan Cancer Hospital, Chengdu 610041, China;
2. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

XUGuohui, Email: XGH0913@hotmail.com

Keywords：

solitary fibrous tumor; multidetector CT; magnetic resonance imaging

DOI：

10.7507/1001-5515.20150029

Video：

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In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly presented as a large solid, well-defined and hypervascular mass with necrosis or cystic changes at some extents together with the displacement of adjacent structures. The radial area with hypointensity on T2-weighted image and with progressive enhancement on enhanced magnetic resonance imaging is an important feature of SFT, which can be helpful for the diagnosis of this mass.

Citation： LIXueming, RENJing, ZHOUPeng, CAOYing, CHENGZhuzhong, YUJianqun, XUGuohui. Multidetector CT and Magnetic Resonance Imaging Features of Solitary Fibrous Tumors in the Pelvis and the Relevant Pathologic Basis Changes. Journal of Biomedical Engineering, 2016, 32(1): 157-162. doi: 10.7507/1001-5515.20150029 Copy

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6.	SHANBHOGUE A K, PRASAD S R, TAKAHASHI N, et al. Somatic and visceral solitary fibrous tumors in the abdomen and pelvis: cross-sectional imaging spectrum[J]. Radiographics, 2011, 31(2): 393-408.
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11.	YI Bing, BEWTRA C, YUSSEF K, et al. Giant pelvic solitary fibrous tumor obstructing intestinal and urinary tract: a case report and literature review[J]. Am Surg, 2007, 73(5): 478-480.
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14.	YOKOI T, TSUZUKI T, YATABE Y, et al. Solitary fibrous tumour: significance of p53 and CD34 immunoreactivity in its malignant transformation[J]. Histopathology, 1998, 32(5): 423-432.
15.	CRANSHAW I M, GIKAS P D, FISHER C, et al. Clinical outcomes of extra-thoracic solitary fibrous tumours[J]. Eur J Surg Oncol, 2009, 35(9): 994-998.
16.	ZERÓN-MEDINA J, RODRÍGUEZ-COVARRUBIAS F, GARC?A-MORA A, et al. Solitary fibrous tumor of the pelvis treated with preoperative embolization and pelvic exenteration[J]. Am Surg, 2011, 77(1): 112-113.
17.	MOSER T, NOGUEIRA T S, NEUVILLE A, et al. Delayed enhancement pattern in a localized fibrous tumor of the liver[J]. Am J Roentgenol, 2005, 184(5): 1578-1580.
18.	ROSADO-DE-CHRISTENSON M L, ABBOTT G F, MCADAMS H P, et al. From the archives of the AFIP: Localized fibrous tumor of the pleura[J]. Radiographics, 2003, 23(3): 759-783.
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20.	毛新峰, 沈健, 黄小燕, 等.腹腔内韧带样型纤维瘤病的CT表现与病理特点[J].医学影像学杂志, 2013, 23(2): 213-216.

1. KLEMPERER P, RABIN C B. Primary neoplasms of the pleura. A report of five cases[J]. Am J Ind Med, 1992, 22(1): 1-31.
2. GENGLER C, GUILLOU L. Solitary fibrous tumour and haemangiopericytoma: evolution of a concept[J]. Histopathology, 2006, 48(1): 63-74.
3. FLETCHER C D. The evolving classification of soft tissue tumours: an update based on the new WHO classification[J]. Histopathology, 2006, 48(1): 3-12.
4. WAT S Y, SUR M, DHAMANASKAR K. Solitary fibrous tumor (SFT) of the pelvis[J]. Clin Imaging, 2008, 32(2): 152-156.
5. JOE B N, BOLARIS M, HORVAI A, et al. Solitary fibrous tumor of the male pelvis: findings at CT with histopathologic correlation[J]. Clin Imaging, 2008, 32(5): 403-406.
6. SHANBHOGUE A K, PRASAD S R, TAKAHASHI N, et al. Somatic and visceral solitary fibrous tumors in the abdomen and pelvis: cross-sectional imaging spectrum[J]. Radiographics, 2011, 31(2): 393-408.
7. ZHANG Weidong, CHEN Jianyu, CAO Yun, et al. Computed tomography and magnetic resonance imaging findings of solitary fibrous tumors in the pelvis: correlation with histopathological findings[J]. Eur J Radiol, 2011, 78(1): 65-70.
8. GINAT D T, BOKHARI A, BHATT S, et al. Imaging features of solitary fibrous tumors[J]. Am J Roentgenol, 2011, 196(3): 487-495.
9. ROSENKRANTZ A B, HINDMAN N, MELAMED J. Imaging appearance of solitary fibrous tumor of the abdominopelvic cavity[J]. J Comput Assist Tomogr, 2010, 34(2): 201-205.
10. WIGNALL O J, MOSKOVIC E C, THWAY K, et al. Solitary fibrous tumors of the soft tissues: review of the imaging and clinical features with histopathologic correlation[J]. Am J Roentgenol, 2010, 195(1): W55-W62.
11. YI Bing, BEWTRA C, YUSSEF K, et al. Giant pelvic solitary fibrous tumor obstructing intestinal and urinary tract: a case report and literature review[J]. Am Surg, 2007, 73(5): 478-480.
12. FRIDLINGTON J, WEAVER J, KELLY B, et al. Secondary hypertrophic osteoarthropathy associated with solitary fibrous tumor of the lung[J]. J Am Acad Dermatol, 2007, 57(5 Suppl): S106-S110.
13. ENGLAND D M, HOCHHOLZER L, MCCARTHY M J. Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases[J]. Am J Surg Pathol, 1989, 13(8): 640-658.
14. YOKOI T, TSUZUKI T, YATABE Y, et al. Solitary fibrous tumour: significance of p53 and CD34 immunoreactivity in its malignant transformation[J]. Histopathology, 1998, 32(5): 423-432.
15. CRANSHAW I M, GIKAS P D, FISHER C, et al. Clinical outcomes of extra-thoracic solitary fibrous tumours[J]. Eur J Surg Oncol, 2009, 35(9): 994-998.
16. ZERÓN-MEDINA J, RODRÍGUEZ-COVARRUBIAS F, GARC?A-MORA A, et al. Solitary fibrous tumor of the pelvis treated with preoperative embolization and pelvic exenteration[J]. Am Surg, 2011, 77(1): 112-113.
17. MOSER T, NOGUEIRA T S, NEUVILLE A, et al. Delayed enhancement pattern in a localized fibrous tumor of the liver[J]. Am J Roentgenol, 2005, 184(5): 1578-1580.
18. ROSADO-DE-CHRISTENSON M L, ABBOTT G F, MCADAMS H P, et al. From the archives of the AFIP: Localized fibrous tumor of the pleura[J]. Radiographics, 2003, 23(3): 759-783.
19. GARCIA-BENNETT J, OLIVÉ CS, RIVAS A, et al. Soft tissue solitary fibrous tumor. Imaging findings in a series of nine cases[J]. Skeletal Radiol, 2012, 41(11):1427-1433.
20. 毛新峰, 沈健, 黄小燕, 等.腹腔内韧带样型纤维瘤病的CT表现与病理特点[J].医学影像学杂志, 2013, 23(2): 213-216.

Journal of Biomedical Engineering

Multidetector CT and Magnetic Resonance Imaging Features of Solitary Fibrous Tumors in the Pelvis and the Relevant Pathologic Basis Changes

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