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Kaya EA, Carlson JD, Thomas CJ, Wagner AE, Fairbanks RK, Lamoreaux WT, Lee CM. Single Solitary Fibrous Tumor Brain Metastasis in a Patient with Simultaneous Adenocarcinoma of the Lung: Case Report and Review of the Literature. Case Rep Med 2020; 2020:3938270. [PMID: 32318112 PMCID: PMC7166291 DOI: 10.1155/2020/3938270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/24/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022] Open
Abstract
We present a unique case of a patient simultaneously diagnosed with solitary fibrous tumor (SFT) and unrelated adenocarcinoma of the lung, both proven with separate pathology. It was subsequently found that the SFT had metastasized to the brain by additional pathology, and not the predicted adenocarcinoma. SFTs are a rare mesenchymal neoplasm that accounts for less than 2% of all reported soft tissue tumors. SFTs most commonly arise in the thoracic cavity, but are frequently found in various locations throughout the body, and rarely metastasize to the brain. This case highlights that rare neoplasms, such as SFT, should not be ruled out as a potential cause of metastasis. Due to the rarity of this clinical situation, we also provide a review and discussion of previously reported SFT cases and the use of postoperative radiation therapy. The optimal treatment for individual patients remains unclear in this unique situation. Surgical resection followed by adjuvant Gamma Knife radiation therapy to the surgical bed appears to be a safe option for local treatment of SFT in select patients. Further studies are needed of this rare clinical situation in order to better understand and optimize future treatments for patients with SFT and metastasis to the brain.
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Affiliation(s)
- Erin A Kaya
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
- Washington State University (WSU) Elson S. Floyd College of Medicine (ESFCOM), Spokane, WA, USA
| | | | | | - Aaron E Wagner
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Robert K Fairbanks
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Wayne T Lamoreaux
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
| | - Christopher M Lee
- Department of Radiation Oncology, Cancer Care Northwest and Gamma Knife of Spokane, Spokane, WA, USA
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Krengli M, Cena T, Zilli T, Jereczek-Fossa BA, De Bari B, Villa Freixa S, Kaanders JH, Torrente S, Pasquier D, Sole CV, Lutsyk M, Dincbas FO, Habboush Y, Fariselli L, Dragan T, Baumert BG, Khanfir K, Ugurluer G, Thariat J. Radiotherapy in the treatment of extracranial hemangiopericytoma/solitary fibrous tumor: Study from the Rare Cancer Network. Radiother Oncol 2020; 144:114-120. [DOI: 10.1016/j.radonc.2019.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 01/06/2023]
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Salas S, Resseguier N, Blay JY, Le Cesne A, Italiano A, Chevreau C, Rosset P, Isambert N, Soulie P, Cupissol D, Delcambre C, Bay JO, Dubray-Longeras P, Krengli M, De Bari B, Villa S, Kaanders JHAM, Torrente S, Pasquier D, Thariat JO, Myroslav L, Sole CV, Dincbas HF, Habboush JY, Zilli T, Dragan T, Khan R K, Ugurluer G, Cena T, Duffaud F, Penel N, Bertucci F, Ranchere-Vince D, Terrier P, Bonvalot S, Macagno N, Lemoine C, Lae M, Coindre JM, Bouvier C. Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French Sarcoma Group (FSG) database. Ann Oncol 2018; 28:1979-1987. [PMID: 28838212 DOI: 10.1093/annonc/mdx250] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Solitary fibrous tumors (SFT) are rare unusual ubiquitous soft tissue tumors that are presumed to be of fibroblastic differentiation. At present, the challenge is to establish accurate prognostic factors. Patients and methods A total of 214 consecutive patients with SFT diagnosed in 24 participating cancer centers were entered into the European database (www.conticabase.org) to perform univariate and multivariate analysis for overall survival (OS), local recurrence incidence (LRI) and metastatic recurrence incidence (MRI) by taking competing risks into account. A prognostic model was constructed for LRI and MRI. Internal and external validations of the prognostic models were carried out. An individual risk calculator was carried out to quantify the risk of both local and metastatic recurrence. Results We restricted our analysis to 162 patients with local disease. Twenty patients (12.3%) were deceased at the time of analysis and the median OS was not reached. The LRI rates at 10 and 20 years were 19.2% and 38.6%, respectively. The MRI rates at 10 and 20 years were 31.4% and 49.8%, respectively. Multivariate analysis retained age and mitotic count tended to significance for predicting OS. The factors influencing LRI were viscera localization, radiotherapy and age. Mitotic count, tumor localization other than limb and age had independent values for MRI. Three prognostic groups for OS were defined based on the number of unfavorable prognostic factors and calculations were carried out to predict the risk of local and metastatic recurrence for individual patients. Conclusion LRI and MRI rates increased between 10 and 20 years so relapses were delayed, suggesting that long-term monitoring is useful. This study also shows that different prognostic SFT sub-groups could benefit from different therapeutic strategies and that use of a survival calculator could become standard practice in SFTs to individualize treatment based on the clinical situation.
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Affiliation(s)
- S Salas
- Department of Medicine, Timone Hospital, Marseille.,Aix Marseille University, Marseille
| | - N Resseguier
- Support Unit for Clinical Research and Economic Evaluatin, Timone Hospital, Marseille
| | - J Y Blay
- Department of Medicine, Leon Berard Center, Lyon
| | - A Le Cesne
- Department of Medicine, Gustave Roussy Institute, Villejuif
| | - A Italiano
- Department of Medicine, Bergonié Institute, Bordeaux
| | - C Chevreau
- Department of Medicine, Claudius Regaud Institute, Toulouse
| | - P Rosset
- Department of Medicine, CHU, Tours
| | - N Isambert
- Department of Medicine, Georges-François Leclerc Institute, Dijon
| | - P Soulie
- Department of Medicine, Paul Papin Institute, Angers
| | - D Cupissol
- Department of Medicine, Val d'Aurelle Institute, Montpellier
| | - C Delcambre
- Department of Medicine, François-Baclesse Institute, Caen
| | - J O Bay
- Department of Medicine, Jean Perrin Institute, Clermont-Ferrand, France
| | - P Dubray-Longeras
- Department of Medicine, Jean Perrin Institute, Clermont-Ferrand, France
| | - M Krengli
- Department of Radiotherapy, University Hospital, Novara, Italy
| | - B De Bari
- Department of Radiotherapy, CHU Vaudois, Lausanne, Switzerland
| | - S Villa
- Department of Radiotherapy, Catalan Institute of Oncology, Badalona Catalonia, Spain
| | - J H A M Kaanders
- Department of Radiotherapy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S Torrente
- Department of Radiotherapy, University Hospital, Novara, Italy
| | - D Pasquier
- Department of Radiotherapy, Centre Oscar Lambret, Lille
| | - J O Thariat
- Department of Radiotherapy, Centre Antoine-Lacassagne, Nice, France
| | - L Myroslav
- Department of Radiotherapy, Rambam HCC, Haifa, Israel
| | - C V Sole
- Department of Radiotherapy, Clinica Instituto de Radiomedicina (IRAM), Santiago, Chile
| | - H F Dincbas
- Department of Radiotherapy, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - J Y Habboush
- Department of Radiotherapy, Mayo Clinic, Jacksonville, USA
| | - T Zilli
- Department of Radiotherapy, HUG, Geneva, Switzerland
| | - T Dragan
- Department of Radiotherapy, Institut J. Bordet Brussels, Brussels, Belgium
| | - K Khan R
- Department of Radiotherapy, CHVR, Sion, Switzerland
| | - G Ugurluer
- Department of Radiotherapy, Adana Hospital, Adana, Turkey
| | - T Cena
- Department of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | - F Duffaud
- Department of Medicine, Timone Hospital, Marseille
| | - N Penel
- Department of Medicine, Oscar Lambret Institute, Lille
| | - F Bertucci
- Department of Medicine, Paoli Calmette Institute, Marseille
| | | | - P Terrier
- Department of Pathology, Gustave Roussy Institute, Villejuif
| | - S Bonvalot
- Department of Surgery, Institut Curie, PSL University, Paris
| | - N Macagno
- Department of Pathology, Timone Hospital, Marseille
| | - C Lemoine
- Support Unit for Clinical Research and Economic Evaluatin, Timone Hospital, Marseille
| | - M Lae
- Department of Pathology, Curie Institute, Paris
| | - J M Coindre
- Department of Pathology, Bergonié Institute, Bordeaux.,University Victor Ségalen, Bordeaux, France
| | - C Bouvier
- Aix Marseille University, Marseille.,Department of Pathology, Timone Hospital, Marseille
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Haas RL, Walraven I, Lecointe-Artzner E, Scholten AN, van Houdt WJ, Griffin AM, Ferguson PC, Miah AB, Zaidi S, DeLaney TF, Chen YL, Spalek M, Krol SDG, Moeri-Schimmel RG, van de Sande MAJ, Sangalli C, Stacchiotti S. Radiation Therapy as Sole Management for Solitary Fibrous Tumors (SFT): A Retrospective Study From the Global SFT Initiative in Collaboration With the Sarcoma Patients EuroNet. Int J Radiat Oncol Biol Phys 2018; 101:1226-1233. [PMID: 29859795 DOI: 10.1016/j.ijrobp.2018.04.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/03/2018] [Accepted: 04/10/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE Solitary fibrous tumors (SFTs) are extremely rare mesenchymal malignancies. Given the lack of large prospective studies on radiation therapy (RT) with definitive and/or palliative intent in SFT patients, this retrospective study aimed to better define the benefit of RT in this disease. METHODS AND MATERIALS A retrospective observational study was performed across 7 sarcoma centers. Clinical information was retrieved from all patients receiving RT without surgery over the course of their locally advanced and/or metastatic disease. Differences in treatment characteristics between subgroups were tested using analysis-of-variance tests. Local control (LC) and overall survival (OS) rates were calculated as time from the start of RT until local progression and death from any cause, respectively. RESULTS Since 1990, a total of 40 patients were identified. RT was applied with definitive intent in 16 patients and with palliative intent in 24. The median follow-up period was 62 months. In patients treated with definitive RT (receiving approximately 60 Gy), the objective response rate was 67%. At 5 years, the LC rate was 81.3%, and the OS rate was 87.5%. In the case of palliative RT (typically 39 Gy), the objective response rate was 38%. The LC and OS rates at 5 years were 62.5% and 54.2%, respectively. In both subgroups, RT-associated toxicities were mild with predominantly grade 1 acute and late side effects. CONCLUSIONS This retrospective study suggests a clinically meaningful benefit for RT given with either definitive or palliative intent without surgery in SFT management. Prospective registries potentially in collaboration with patient advocacy groups are warranted to further assess the role of RT in patients with this rare malignancy.
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Affiliation(s)
- Rick L Haas
- Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Iris Walraven
- Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Astrid N Scholten
- Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Winan J van Houdt
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anthony M Griffin
- Division of Orthopedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Peter C Ferguson
- Division of Orthopedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Aisha B Miah
- Department of Radiotherapy and Physics, Sarcoma Unit, Royal Marsden Hospital, London, UK
| | - Shaine Zaidi
- Department of Radiotherapy and Physics, Sarcoma Unit, Royal Marsden Hospital, London, UK
| | - Thomas F DeLaney
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Yen-Lin Chen
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Mateusz Spalek
- Department of Radiation Oncology, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Stijn D G Krol
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Claudia Sangalli
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvia Stacchiotti
- Adult Mesenchymal and Rare Tumor Unit, Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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