Clinical Report: Malignant Solitary Fibrous Tumor in HIV-Positive Patient
Background
Malignant solitary fibrous tumors (MSFT) are rare spindle cell neoplasms that can exhibit aggressive behavior and are particularly challenging to diagnose in immunocompromised patients, such as those with HIV. Accurate differentiation from other sarcomas is crucial for effective treatment planning, especially given the potential for metastasis and significant morbidity associated with these tumors.
Data Highlights
No numerical data available in the source material.
Key Findings
The patient presented with a 10.0 cm x 8.0 cm x 4.0 cm mass in the cervical region, associated with neurological symptoms.
Imaging studies revealed an osteolytic lesion affecting the C3-C5 vertebrae and multiple pulmonary nodules.
Initial biopsy suggested a mesenchymal malignant tumor, potentially a BCOR-altered sarcoma.
Neoadjuvant chemotherapy was administered prior to surgical resection, following 2024 CSCO guidelines.
Histopathological analysis confirmed the diagnosis of MSFT, with markers such as STAT6+, CD34+, and Ki-67 ~60%.
The case emphasizes the importance of thorough pathological evaluation in distinguishing MSFT from other sarcomas in HIV-infected patients.
Clinical Implications
This case underscores the necessity for comprehensive immunohistochemical profiling in diagnosing rare sarcomas like MSFT, particularly in immunocompromised patients. Clinicians should be aware of the potential for misdiagnosis and the importance of multidisciplinary approaches in managing complex cases.
