Solitary fibrous tumor of the thyroid gland: Report of two cases and review of the literature

Department of Pathology, Faculty of Medicine, Oita University, Yufu, and Department of Otolaryngology, Nankai Hospital, Saiki, Japan.
Pathology International (Impact Factor: 1.69). 09/2006; 56(8):471-7. DOI: 10.1111/j.1440-1827.2006.01992.x
Source: PubMed


Presented herein are the first two Japanese cases of solitary fibrous tumor (SFT) of the thyroid gland. The patients were 64- and 41-year-old men, who underwent hemithyroidectomy for thyroid tumors. Histopathologically, the tumors were well circumscribed, and were composed of spindle cells, collagen bundles and entrapped thyroid follicles. Spindle cells and collagen bundles were mostly in a patternless arrangement with an admixture of hypo- and hypercellular areas. Proliferating spindle cells were bland, slender, and occasionally wavy without any atypia and increased mitotic figures. Immunohistochemically, they were strongly positive for CD34, CD99, and bcl-2, but negative for epithelial membrane antigen, keratin, thyroglobulin, calcitonin, thyroid transcription factor-1, alpha-smooth muscle actin, desmin, S-100 protein and CD117. Based on these findings, the two patients were diagnosed as having thyroid SFT. Neither local recurrence nor metastasis has been observed in 5 years in patient 1 or in 4 years in patient 2. Thyroid SFT is extremely rare, and only 20 cases have been reported in the English-language literature including hemangiopericytoma. Although recurrence or metastasis has not been described in any reported cases, the clinical behavior of SFT is still undetermined, therefore long-term follow up seems necessary at present.

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    • "spindle fibroblast-like cells growing in patternless manner with variable amounts of intercellular collagen bundles, keloid-like hyalinization, and alternating hypercellular and hypocellular areas [23]. Immunohistochemically, benign SFTs generally showed strong positive reactions for CD34, vimentin, and bcl-2 but negative for SMA, desmin, and S-100 protein [11]. "
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    ABSTRACT: A 68-year-old man had a rapidly growing, painless neck mass, thought to be nodular goiter. Ultrasonography showed a giant, heterogeneous mass occupying the middle and superior poles and protruding outside of the left thyroid lobe. The results of the thyroid function tests were normal. Thyroid scintigraphy revealed a large hypoactive nodule in the left thyroid lobe. Complete surgical removal of tumor was performed and macroscopically demonstrated a well-demarked lesion outside the thyroid gland. Microscopically, the lesion was composed of fibroblast-like spindle cells in a patternless architecture and extensive stromal hyalinization. Immunohistochemistry showed positive reaction for CD34 in spindle cells and diffuse bcl-2 staining. The pathology was confirmed as solitary fibrous tumor. In the follow-up period after surgery, thyroid scintigraphy showed normal left thyroid lobe. Solitary fibrous tumor originated from or associated with thyroid gland is extremely rare. According to our knowledge, this is the first reported solitary fibrous tumor presenting like a cold thyroid nodule. This pathology must be considered for differential diagnosis of neck masses in the thyroid region.
    Case Reports in Endocrinology 10/2013; 2013(4-5):805745. DOI:10.1155/2013/805745
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    • "Subsequently, over the past decade, its occurrence was also reported at many extrapleural sites, e.g. adrenal glands [36], thyroid gland [40], sublingual glands [33], prostate [25], liver [5], kidneys [13] [21], pancreas [6], orbit [38] [47], spinal cord [35], breast [4] [12], periosteum [32], nasal cavity and the nasopharynx [29], or the mediastinum [31]. This led to the exclusion of its mesothelial origin, and owing to its positive immunohistochemical staining for CD34, a mesenchymal histogenesis was presumed. "
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    ABSTRACT: Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that occurs preferentially in the pleura. Although it has been described at some extrathoracic sites, its occurrence in the female genital tract is extremely rare. We are the first to report on an unusual case of a large (14cm in the largest diameter) SFT localized in the broad ligament of the uterus in a 50-year-old woman. The patient underwent surgical tumor extirpation and has remained well without any sign of local tumor recurrence after 6 years of follow-up. We discuss the clinical aspects, the gross macroscopic appearance, the histologic findings, and the differential diagnosis, and provide a review of the literature.
    Pathology - Research and Practice 02/2007; 203(7):555-60. DOI:10.1016/j.prp.2007.02.005 · 1.40 Impact Factor
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    ABSTRACT: Solitary fibrous tumor (SFT) is a rare spindle cell tumor most often found in the mediastinal pleura. Nineteen cases of SFT arising in the thyroid gland have been reported. We report a case of SFT of the thyroid gland with immunohistochemical and cytogenetic investigation. A 58-year-old man had pulmonary symptoms, thought to be asthma. Computed tomographic scan revealed a large goiter with a solid hyperechoic nodule. The results of thyroid function tests were normal. Microscopically, the lesion was composed of fibroblast-like spindle cells in a patternless growth. Cellular atypia or necrosis was not seen, and mitotic activity was low. Immunohistochemistry showed positive reaction for CD34, vimentin, bcl-2, and CD99. Fluorescence in situ hybridization analysis of more than 100 cells exhibited no trisomy 21. Complete surgical removal of tumor is the treatment of choice. The histological appearance and immunohistochemical reaction pattern of SFT is characteristic. The entity should be considered when dealing with a spindle cell lesion in the thyroid gland. All cases of this site of origin reported have had a benign clinical course. As only a small number of cases have been described, we recommend long-term follow-up.
    Thyroid: official journal of the American Thyroid Association 04/2010; 20(4):435-7. DOI:10.1089/thy.2009.0237 · 4.49 Impact Factor
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