PMC9376293_01
(A) and (B) were abdominal wall tumor(7x5x8 cm), left pelvic tumor(5.5x3.5x7 cm) and right iliac paravascular tumor(8.5x3x5 cm) before treatment, while (C) and (D) were left pelvic and right iliac paravascular tumors without recurrence 43 months after surgery+125I seed implantation.
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On June 29, 2015, the patient visited our hospital and had abdominal and pelvic CT examination, which indicated multiple space-occupying lesions in the abdominal wall and pelvic cavity (Figure 1).
(A):hypercellular areas(HE x100). (B):hypercellular area with atypical nuclei and some evident mitotic figures(HE x200). (C):Tumor cells are diffusely positive for CD99(IHCx200). (D):Tumor cells are diffusely positive for STAT6 (IHC x100).
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Postoperative pathology showed recurrent solitary fibrous tumor, considered low-grade malignancy, and the immunohistochemistry results were as follows:CD99 (Weak +), CD34 (blood vessels+), SMA (-), Bcl-2 (+), Vimentin(+), Wide CK(-), S-100(-), Desmin(-), CR(-), MC(-), Ki-67 (10% positive) (Figures 2A-C).125I seed implantation was performed, in which 30 seeds (0.3 mCi) were implanted into the tumor bed near the right iliac vessels, with D90 of 62.0 Gy, and 32 seeds (0.5 mCi) into the tumor bed of the left pelvic cavity, with D90 of 58.0 Gy; the operation was smooth, and postoperative pathology came back as a recurrent low-grade MSFT.
(A) and (B) were behind bladder tumors before treatment with size of about 4x3x5.0 cm, 3.0x2.0x2.5cm respectively, and (C) and (D) were two years after 125I seed implantation.
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D90 of 49.7 Gy measured post implant. Dose-volume histogram parameters were applied for the evaluation of target volume and organs at risk (OARs).The patient's regular examinations after implants revealed a complete remission (Figure 3).
(A) was the recurrence of abdominal wall tumor with a size of about 4.0x2.5x4.5 cm before treatment in 2016/1, (B) was 6 months after 125I seed implantation, (C) was the recurrence of abdominal wall tumor(3.6x1.5x3.0 cm) and behind bladder tumors(5.0x3.0x5.0 cm) before treatment in 2018/10, (D) was 4 months after 125I seed implantation.
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The patient achieved a complete remission, no complications were found, and the brachytherapy was well tolerated by the patient, The patient had no recurrence of abdominal and pelvic tumors during the 4-month follow-up (Figure 4).