Sarcopedia

IntermediateSoft tissue

Solitary Fibrous Tumour

Synonyms: Hemangiopericytoma (now reclassified as SFT)

Intermediate-grade with Variable behaviour

Quick Facts

Behaviour

Intermediate

Category

Soft tissue

Grade

Variable

Synonyms

Hemangiopericytoma (now reclassified as SFT)

Category

Soft tissue

Behaviour

Intermediate

Grade

Variable

Gender

M = F

Tissue of Origin

Fibrous

Epidemiology

  • Intermediate-grade mesenchymal tumour
  • Peak incidence 4th-6th decades
  • Can occur in various sites
  • NAB2-STAT6 fusion characteristic

Clinical Features

  • Often asymptomatic incidental finding
  • Slow-growing
  • Larger lesions may cause mass effect
  • Hypoglycaemia if large (paraneoplastic)

Location

  • Soft tissues (extremities, trunk)
  • Pleura and lung
  • Meninges
  • Liver
  • Orbit

Imaging

  • MRI: homogeneous or heterogeneous
  • T1 isointense, Variable T2
  • Well-demarcated
  • Significant Vascularity possible

Pathology

  • Bland spindle cells in fascicles or storiform pattern
  • Prominent branching haemangiopericytoma-like vasculature
  • NAB2-STAT6 fusion confirmatory
  • STAT6+ on immunostain

Genetics

NAB2-STAT6 fusion 90%

Treatment

  • Wide surgical excision: primary treatment
  • Risk assessment important (size, mitotic rate)
  • Adjuvant radiotherapy: High-risk lesions
  • Chemotherapy/VEGF inhibitors: for unresectable or progressive

Prognosis

  • Variable based on risk: Low-risk excellent, High-risk 50-60% 5-year
  • Recurrence and metastasis possible especially High-risk

Key Points

  • Intermediate-grade with Variable behaviour
  • Risk assessment scheme guides treatment
  • NAB2-STAT6 fusion diagnostic

Workup - Blood Tests

Glucose: screen for hypoglycaemia

Workup - Local Imaging

  • MRI primary site: assess size and extent
  • CT chest/abdomen: baseline for High-risk

Workup - Biopsy

STAT6 immunostain: NAB2-STAT6 fusion indicator

Workup - Staging

No standard staging

Medical disclaimer

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