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An abdominal-sacral approach with preoperative embolisation for vulvar solitary fibrous tumour : a case report.

Takahashi Akimasa 50452248 0000-0001-5698-553X NISHIMURA Hiroki AMANO Tsukuru 20613467 0000-0003-2919-6337 DEGUCHI Mari 80866674 YOSHINO Fumi 80757170 KASEI Ryo KIMURA Fuminori 90322148 0000-0002-9840-4227 MORITANI Suzuko 20283559 MURAKAMI Takashi 20240666 0000-0002-0250-0856 滋賀医科大学

2021.03.29

概要

Background:
Solitary fibrous tumours (SFTs) in the female genital tract are uncommon. Resection of these tumours is controversial because it can cause life-threatening haemorrhage. We report a case of vulvar SFT that was excised in a combined abdominal-sacral approach after preoperative embolisation.
Case presentation:
At another hospital, an inoperable intrapelvic tumour was diagnosed in a 34-year-old woman. Computed tomography and magnetic resonance imaging showed that the uterus, urinary bladder and rectum were compressed laterally by a pelvic tumour with a maximum diameter of 11 cm. This mass was hypervascular and had a well-defined border. Transperineal biopsy was performed, and immunostaining revealed that the mass was an SFT. The tumour was supplied by feeding vessels from the right iliac arteries. First, we embolised the feeding vessels. Second, we performed surgical resection in a combined abdominal-sacral approach; no blood transfusion was necessary, and no perioperative complications occurred. The final pathological diagnosis was SFT that was positive for CD34 and signal transducer and activator of transcription 6 according to immunohistochemical staining.
Conclusion:
During a year of follow-up, the disease did not recur. Treatment of pelvic SFT should aim at complete resection through various approaches after careful measures are taken to prevent haemorrhage.

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