A 57-year-old woman presented to our hospital with dyspnea and chest pain of which she had been aware. A chest CT scan revealed an 18 × 13 cm chest wall tumor in the right thoracic cavity. CT-guided percutaneous needle biopsy led to a diagnosis of solitary fibrous tumor (SFT). It was difficult to differentiate whether the tumor was benign or malignant based on CT, MRI and FDG-PET findings. In December 2020, we performed thoracoscopic-assisted tumor excision. The histopathological study revealed patternless proliferation of spindle-shaped cells. The mitotic figure was 16/10HPF. Immunostaining studies showed CD34 positive and STAT6 positive. From these findings, we diagnosed the case as high-risk malignant SFT. The surgical stump was negative, indicating that a surgical complete resection could be achieved. No adjuvant chemotherapy was added, and the patient has been followed without any therapies.
Malignant SFT is an extremely rare entity, and its diagnostic criteria are still obscure. However, the risk of recurrence has been described in a variety of reports. We here present a case of SFT which was diagnosed as malignant and treated by surgical resection, with literature review.
"},{"@language":"ja","@value":"症例は57歳，女性．呼吸苦，胸痛を自覚していた．胸部CTで右胸腔内に18×13cm大の胸壁腫瘍を認め，CTガイド下経皮針生検を施行した結果，孤立性線維性腫瘍（SFT）の診断となった．CT，MRI，FDG-PET所見からは良悪性の診断が困難であった．2020年12月，胸腔鏡補助下で腫瘍摘出術が施行された．術後の病理組織学的検査の結果，紡錘形細胞がpatternlessに増殖する所見を認めた．核分裂像は16個/10HPFであり，免疫染色はCD34陽性，STAT6陽性であった．以上より，高リスク悪性SFTの診断となった，切除断端は陰性であり，外科的完全切除を施行できた．術後補助療法は施行せず，無治療経過観察中である．悪性SFTは非常に稀な疾患であり，診断基準が明確でないが，再発リスクについては様々な文献で報告されている．今回，悪性SFTと診断し，外科的切除術を施行した1例を経験したので，若干の文献的考察を加えて報告する．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410580461189752963","@type":"Researcher","foaf:name":[{"@language":"en","@value":"YOSHINO Ryusei"},{"@language":"ja","@value":"吉野 流世"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Surgery, Asahikawa Medical University"},{"@language":"ja","@value":"旭川医科大学呼吸器乳腺外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410580461189752961","@type":"Researcher","foaf:name":[{"@language":"en","@value":"YOSHIDA Nana"},{"@language":"ja","@value":"吉田 奈七"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Surgery, Asahikawa Medical University"},{"@language":"ja","@value":"旭川医科大学呼吸器乳腺外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410580461189752967","@type":"Researcher","foaf:name":[{"@language":"en","@value":"YASUDA Shunsuke"},{"@language":"ja","@value":"安田 俊輔"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学呼吸器乳腺外科"},{"@language":"en","@value":"Department of Surgery, Asahikawa Medical University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410580461189752960","@type":"Researcher","foaf:name":[{"@language":"en","@value":"ITO Akane"},{"@language":"ja","@value":"伊藤 茜"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学呼吸器乳腺外科"},{"@language":"en","@value":"Department of Surgery, Asahikawa Medical University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410580461189752962","@type":"Researcher","foaf:name":[{"@language":"en","@value":"NAKATSUBO Masaki"},{"@language":"ja","@value":"中坪 正樹"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学呼吸器乳腺外科"},{"@language":"en","@value":"Department of Surgery, Asahikawa Medical University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410580461189752964","@type":"Researcher","foaf:name":[{"@language":"en","@value":"HAYASHI Manami"},{"@language":"ja","@value":"林 真奈実"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学病理部"},{"@language":"en","@value":"Department of Diagnostic Pathology, Asahikawa Medical University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410580461189752966","@type":"Researcher","foaf:name":[{"@language":"en","@value":"KITADA Masahiro"},{"@language":"ja","@value":"北田 正博"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学呼吸器乳腺外科"},{"@language":"en","@value":"Department of Surgery, Asahikawa Medical University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410580461189752965","@type":"Researcher","foaf:name":[{"@language":"en","@value":"TANINO Mishie"},{"@language":"ja","@value":"谷野 美智枝"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Diagnostic Pathology, Asahikawa Medical University"},{"@language":"ja","@value":"旭川医科大学病理部"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13452843"},{"@type":"EISSN","@value":"18825133"},{"@type":"NDL_BIB_ID","@value":"000000107238"},{"@type":"ISSN","@value":"13452843"},{"@type":"LISSN","@value":"13452843"},{"@type":"NCID","@value":"AA11189709"}],"prism:publicationName":[{"@language":"en","@value":"Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)"},{"@language":"ja","@value":"日本臨床外科学会雑誌"},{"@language":"en","@value":"Nihon Rinsho Geka Gakkai Zasshi (J Jpn Surg Assoc)"},{"@language":"en","@value":"J Jpn Surg Assoc"},{"@language":"en","@value":"J. Jpn. Surg. Assoc."},{"@language":"ja","@value":"日臨外会誌"},{"@language":"en","@value":"Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)"},{"@language":"ja","@value":"日本臨床外科学会雑誌"}],"dc:publisher":[{"@language":"en","@value":"Japan Surgical Association"},{"@language":"ja","@value":"日本臨床外科学会"}],"prism:publicationDate":"2023","prism:volume":"84","prism:number":"7","prism:startingPage":"1032","prism:endingPage":"1037"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"http://id.ndl.go.jp/bib/033000142"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I033000142"},{"@id":"https://www.jstage.jst.go.jp/article/jjsa/84/7/84_1032/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2023298175"}],"availableAt":"2023","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E6%82%AA%E6%80%A7%E5%AD%A4%E7%AB%8B%E6%80%A7%E7%B7%9A%E7%B6%AD%E6%80%A7%E8%85%AB%E7%98%8D","dc:title":"悪性孤立性線維性腫瘍"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%AD%A4%E7%AB%8B%E6%80%A7%E7%B7%9A%E7%B6%AD%E6%80%A7%E8%85%AB%E7%98%8D","dc:title":"孤立性線維性腫瘍"},{"@id":"https://cir.nii.ac.jp/all?q=STAT6","dc:title":"STAT6"},{"@id":"https://cir.nii.ac.jp/all?q=malignant%20solitary%20fibrous%20tumor","dc:title":"malignant solitary 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