盆腔腹膜后恶性孤立性纤维性肿瘤一例

doi:10.12280/gjfckx.20251118

摘要/Abstract

摘要：

孤立性纤维性肿瘤（solitary fibrous tumor，SFT）是一种罕见的间叶组织来源的梭形细胞肿瘤，恶性SFT（malignant SFT，mSFT）更具侵袭性，发生于盆腔腹膜后者尤为罕见。报告1例55岁女性患者，因间断右下腹痛2年余，加重1周就诊，影像学提示右侧附件区占位性病变，行腹腔镜手术切除后，术后病理结合免疫组织化学结果确诊为mSFT。结合近年文献，从流行病学、临床表现、影像学特征、病理诊断、鉴别诊断、治疗及预后等方面进行系统分析，旨在提高临床医生对盆腔腹膜后mSFT的早期识别与综合诊治能力。

关键词: 孤立性纤维瘤, 腹膜后肿瘤, STAT6转录因子, 磁共振成像, 免疫组织化学

Abstract:

Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm of mesenchymal origin, and malignant SFT (mSFT) is more aggressive. Occurrence in the pelvic retroperitoneum is exceptionally rare. We report a case of a 55-year-old female who presented with intermittent right lower abdominal pain for over two years, which worsened over the previous week. Imaging revealed a space-occupying lesion in the right adnexal region. The lesion was resected via laparoscopic surgery, and postoperative pathology combined with immunohistochemical findings confirmed mSFT. Based on recent literature, we systematically analyze this case from epidemiological, clinical, imaging, and pathological, differential diagnostic, therapeutic, and prognostic perspectives, aiming to enhance clinicians' ability for early recognition and comprehensive management of pelvic retroperitoneal mSFT.

Key words: Solitary fibrous tumors, Retroperitoneal neoplasms, STAT6 transcription factor, Magnetic resonance imaging, Immunohistochemistry

令菲菲, 胡晓红, 李红丽, 刘畅. 盆腔腹膜后恶性孤立性纤维性肿瘤一例[J]. 国际妇产科学杂志, 2026, 53(2): 228-232.

LING Fei-fei, HU Xiao-hong, LI Hong-li, LIU Chang. A Case of Malignant Solitary Fibrous Tumor in the Pelvic Retroperitoneum[J]. Journal of International Obstetrics and Gynecology, 2026, 53(2): 228-232.

图/表 2

参考文献 25

[1]	Kc S, Poudyal H. Solitary fibrous tumor of the Pelvic cavity: A rare entity with review of literature[J]. Radiol Case Rep, 2024, 19(10):4363-4368. doi: 10.1016/j.radcr.2024.06.087.
[2]	Klemperer P, Coleman BR. Primary neoplasms of the pleura. A report of five cases[J]. Am J Ind Med, 1992, 22(1):1-31. doi: 10.1002/ajim.4700220103. pmid: 1415270
[3]	Piccinelli ML, Law K, Incesu RB, et al. Demographic and Clinical Characteristics of Malignant Solitary Fibrous Tumors: A SEER Database Analysis[J]. Cancers(Basel), 2024, 16(19):3331. doi: 10.3390/cancers16193331.
[4]	Takehara M, Ashihara K, Fukunishi T, et al. Malignant retroperitoneal solitary fibrous tumor co-existing with Meigs' syndrome: A case report[J]. Radiol Case Rep, 2023, 18(12):4553-4557. doi: 10.1016/j.radcr.2023.09.073.
[5]	Pantoja Pachajoa DA, Palacios Huatuco RM, Sambuelli G, et al. Surgical resection of a presacral solitary fibrous tumor with extension to iliac vessels using Karakousis's abdominoinguinal approach: Report of a rare case[J]. Int J Surg Case Rep, 2021, 83:106011. doi: 10.1016/j.ijscr.2021.106011.
[6]	Imen S, Nayssem K, Amine BM, et al. Diagnosis and management of an extremely rare solitary fibrous tumor in the retropubic space of Retzius: A case report[J]. Int J Surg Case Rep, 2023, 110:108717. doi: 10.1016/j.ijscr.2023.108717.
[7]	李玉伟, 陈华成, 高峻, 等. 腹膜后间隙和盆腔腹膜外间隙连通性肿瘤性病变的CT和MRI诊断[J]. 临床放射学杂志, 2025, 44(1):170-174. doi: 10.3969/j.issn.1001-9324.2025.1.lcfsxzz202501032.
[8]	Denewar FA, Takeuchi M, Khedr D, et al. Solitary fibrous tumors from A to Z: a pictorial review with radiologic-pathologic correlation[J]. Insights Imaging, 2025, 16(1):112. doi: 10.1186/s13244-025-01991-x.
[9]	陈妙勤, 成启华. 良恶性胸腹部孤立性纤维瘤的CT和MRI影像学特征及与病理学的对照分析[J]. 现代医用影像学, 2024, 33(9):1657-1660. doi: 10.3969/j.issn.1006-7035.2024.09.022.
[10]	Liu Y, Wang Q, Zhang T, et al. MR imaging of intracranial solitary fibrous tumor: a retrospective study of 7 cases[J]. Afr Health Sci, 2018, 18(3):799-806. doi: 10.4314/ahs.v18i3.39. pmid: 30603014
[11]	Wang YX, Zhong Y, Fan SS, et al. Solitary Fibrous Tumors of the Lung: A Clinicopathological Analysis of 52 Cases[J]. Curr Oncol, 2023, 30(2):1784-1793. doi: 10.3390/curroncol30020138.
[12]	Doyle LA, Vivero M, Fletcher CD, et al. Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics[J]. Mod Pathol, 2014, 27(3):390-395. doi: 10.1038/modpathol.2013.164.
[13]	Sugita S, Segawa K, Kikuchi N, et al. Prognostic usefulness of a modified risk model for solitary fibrous tumor that includes the Ki-67 labeling index[J]. World J Surg Oncol, 2022, 20(1):29. doi: 10.1186/s12957-022-02497-2. pmid: 35105348
[14]	Machado I, Nieto Morales MG, Cruz J, et al. Solitary Fibrous Tumor: Integration of Clinical, Morphologic, Immunohistochemical and Molecular Findings in Risk Stratification and Classification May Better Predict Patient outcome[J]. Int J Mol Sci, 2021, 22(17):9423. doi: 10.3390/ijms22179423.
[15]	Zhu H, Zhu H. Diagnostic and management strategies for retroperitoneal leiomyosarcoma invading the inferior vena cava: a case report[J]. Discov Oncol, 2025, 16(1):1669. doi: 10.1007/s12672-025-03552-6. pmid: 40892127
[16]	Hirota S. Differential diagnosis of gastrointestinal stromal tumor by histopathology and immunohistochemistry[J]. Transl Gastroenterol Hepatol, 2018, 3:27. doi: 10.21037/tgh.2018.04.01. pmid: 29971258
[17]	袁军, 尹晓娜, 任鹏, 等. 子宫炎症性肌纤维母细胞肿瘤5例临床病理分析[J]. 现代实用医学, 2018, 30(12):1650-1651. doi: 10.3969/j.issn.1671-0800.2018.12.042.
[18]	宋嘉敏, 郭顺林. 腹膜后黏液纤维肉瘤1例[J]. 实用放射学杂志, 2025, 41(6):1074-1075. doi: 10.3969/j.issn.1002-1671.2025.06.042.
[19]	Li C, Yang J, Chen H, et al. A giant solitary fibrous tumor of the abdominal pelvic cavity: A case report and literature review[J]. Medicine(Baltimore), 2024, 103(32):e39270. doi: 10.1097/MD.0000000000039270.
[20]	张展志, 刘星凯, 闫凤彩, 等. 18例孤立性纤维瘤的临床病理特点分析及蛋白质组学探索[J]. 现代肿瘤医学, 2023, 31(11):2086-2094. doi: 10.3969/j.issn.1672-4992.2023.11.021.
[21]	Li DM, Tang D, Qie MR, et al. Exploring intraoperative hemorrhage and early recurrence in pelvic malignant solitary fibrotic tumors: a case report and literature review[J]. Front Oncol, 2025, 15:1531597. doi: 10.3389/fonc.2025.1531597.
[22]	Zhang R, Yang Y, Hu C, et al. Comprehensive analysis reveals potential therapeutic targets and an integrated risk stratification model for solitary fibrous tumors[J]. Nat Commun, 2023, 14(1):7479. doi: 10.1038/s41467-023-43249-4. pmid: 37980418
[23]	Liu L, Chen S, Wang L. Retroperitoneal malignant solitary fibrous tumor with second recurrence and lymphatic metastases: A case report[J]. Oncol Lett, 2023, 25(2):57. doi: 10.3892/ol.2022.13643. pmid: 36644135
[24]	Hashimoto K, Nishimura S, Ito T, et al. Total management of hemangiopericytoma/solitary fibrous tumor of the buttock: A case report[J]. Medicine(Baltimore), 2024, 103(29):e39044. doi: 10.1097/MD.0000000000039044.
[25]	Chen L, Wang R, He J, et al. Clinical outcomes of patients undergoing reoperation with solitary fibrous tumors/hemangiopericytomas and malignant progression of tumors[J]. Neurosurg Rev, 2024, 47(1):773. doi: 10.1007/s10143-024-02956-2. pmid: 39387992