A Case of a Giant Solitary Fibrous Tumor Safely Resected with Preoperative Transcatheter Arterial Embolization (TAE)

Abstract

A 78-year-old man presented with abdominal distension and was referred to our hospital for surgery after a retroperitoneal tumor was detected on contrast-enhanced abdominal computed tomography (CT) at a previous hospital. On initial examination, a mass was palpable in the left upper quadrant of the abdomen. Contrast-enhanced abdominal CT showed a 15-cm mass with enhancement in the left upper quadrant of the abdomen. The tumor's feeding vessels included the left fourth lumbar artery, left iliolumbar artery, and branches of the internal iliac artery. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) showed the tumor to be a solitary fibrous tumor (SFT). Due to the risk of bleeding, preoperative transcatheter arterial embolization (TAE) was performed to occlude the feeding vessels, including the left fourth lumbar artery, left iliolumbar artery, and branches of the internal iliac artery, followed by surgical resection. Intraoperative findings showed an elastic, soft tumor in the left abdomen. The left iliolumbar artery and branches of the left internal iliac artery were ligated and divided, and the tumor was excised en bloc. On histopathological examination, densely proliferating spindle cells interspersed with numerous blood vessels were seen, confirming the diagnosis of SFT. This is an extremely rare case and is, therefore, reported.