Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2020; 8(2): 343-352
Published online Jan 26, 2020. doi: 10.12998/wjcc.v8.i2.343
Malignant solitary fibrous tumor of the pancreas with systemic metastasis: A case report and review of the literature
Hao Geng, Yu Ye, Yun Jin, Bai-Zhou Li, Yuan-Quan Yu, Yang-Yang Feng, Jiang-Tao Li
Hao Geng, Yu Ye, Yun Jin, Yuan-Quan Yu, Yang-Yang Feng, Jiang-Tao Li, Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Bai-Zhou Li, Department of Pathology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Author contributions: Geng H, Ye Y, and Feng YY collected the data, reviewed the literature, and contributed to manuscript drafting; Li JT, Jin Y, and Yu YY were the patient’s surgeons and contributed to manuscript drafting; Li BZ performed the histological analyses and interpretation; Li JT was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported by National Natural Science Foundation of China, No. 81770614 and No. 81570559; Training project of health high level talents in Zhejiang Province (2014).
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jiang-Tao Li, FACS, MD, Director, Surgeon, Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, Zhejiang Province, China. zrljt@zju.edu.cn
Received: December 5, 2019
Peer-review started: December 5, 2019
First decision: December 11, 2019
Revised: December 18, 2019
Accepted: December 22, 2019
Article in press: December 22, 2019
Published online: January 26, 2020
Abstract
BACKGROUND

Pancreatic solitary fibrous tumor (SFT) is a rare neoplasm of intermediate biological potential. So far, only 22 cases have been reported since 1999. All the cases, except one, exhibited benign features. Here, we report the first case of malignant pancreatic SFT with typical Doege-Potter syndrome, along with the clinical and pathologic evidence of its systemic metastasis.

CASE SUMMARY

The patient was a 48-year-old man with a 1-year history of pancreatic and liver masses and refractory hypoglycemia. Increased uptake of the tracer fluorodeoxyglucose (FDG) was found in the liver and bones by fluorine-18 FDG positron emission tomography/computed tomography. After multidisciplinary discussion, a distal pancreatectomy procedure was performed, and histological examination showed a lesion composed of abundant heterogeneous spindle cells with localized necrosis. On immunohistochemistry evaluation, STAT6 was found to be diffusely expressed in the tumor. Based on the overall evidence, the patient was diagnosed with malignant pancreatic SFT with liver and bone metastases.

CONCLUSION

The diagnosis of malignant SFT requires comprehensive evidence including clinical, immunohistochemistry, and histological features. This case may be presented as a reference for diagnoses and management of malignant pancreatic SFTs with systemic metastasis.

Keywords: Solitary fibrous tumor, Pancreas, Malignant, Doege-Potter syndrome, Case report

Core tip: Solitary fibrous tumor is now considered as a fibroblastic mesenchymal neoplasm of intermediate biological potential, and it rarely occurs in the pancreas. Here, we report a case of malignant pancreatic solitary fibrous tumor with systemic metastasis, review the literature, and discuss its biological features, diagnosis, and prognosis evaluations.