A Giant Solitary Fibrous Tumor of the Liver with Metastasis and Local Recurrence

2020 
Solitary fibrous tumor (SFT) is a rare type of mesenchymal neoplasm. Although the majority of SFTs are benign, some cases have shown characteristics of malignant neoplasms. Weight loss, fatigue, and upper abdominal bloating are the main signs of these lesions. Clinical and radiographic features are not sufficient for the diagnosis of hepatic SFT and the definitive diagnosis depends on histopathological sampling and immunohistochemistry. One of the main issues in the diagnosis of this tumour is the ability of this tumour to grow to large sizes. A 69-year-old male presented to the clinic 2 years earlier with episodes of hypoglycemia and loss of consciousness. The symptoms improved after receiving glucose. The patient diagnosed as rare solitary fibrous tumour of the liver, a giant (10 × 10 cm in diameter) round and well-defined lesion in the left lobe of the liver which was obvious in magnetic resonance imaging (MRI). Surgery is the most common line of treatment for this disease and there is no evidence regarding the effectiveness of other approaches. According to the scarcity of hepatic SFT, long-term prognosis in these patients is highly challenging. Here, we present the case of a 69-year-old male patient with hepatic SFT with metastasis and local recurrence. In the very rare malignant form of liver solitary fibrous tumour which is surgically unresectable, liver transplantation is one of the potential options but maybe not amenable due to the malignant behaviour of the disease. Role of debulking surgery is also not clear in this situation.
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