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Solitary fibrous tumor (SFTs) are rare mesenchymal neoplasms characterized by spindle cell proliferation in association with a network of thin branching vessels (staghorn).

https://doi.org/10.1016/j.ejrad.2021.110053

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It includes what was previously classified as hemangiopericytoma (HPC), now unified under SFT/HPC spectrum per the WHO 2021 CNS Tumor Classification.

Pathology


Molecular features:

Feature Details
Cell of origin Mesenchymal (fibroblastic/myofibroblastic)
Genetic hallmark NAB2–STAT6 gene fusion (pathognomonic)
Immunostaining STAT6 nuclear positivity, CD34+, BCL-2+, CD99+
WHO Grades – Grade 1: Benign (classic SFT)
– Grade 2: Intermediate cellularity
– Grade 3: Malignant (former hemangiopericytoma, high mitotic index)

Histopathology


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Solitary fibrous tumor (SFT) is composed of spindled to ovoid cells in a patternless architecture with prominent stromal collagen and hemangiopericytoma-like vessels.

https://doi.org/10.1038/modpathol.2013.164

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Feature Description
Classic SFT Spindle cells with collagenous stroma, staghorn vasculature
High-grade SFT / HPC Increased mitoses, necrosis, cellularity, nuclear pleomorphism
IHC Markers STAT6 nuclear staining, CD34+, BCL-2+, CD99+, vimentin+

https://doi.org/10.3390/cancers13122913

https://www.actasdermo.org/es-cutaneous-solitary-fibrous-tumor-a-articulo-S1578219017304316

https://doi.org/10.1186/s13000-021-01095-2

https://doi.org/10.3390/cancers13102470

https://doi.org/10.1038/modpathol.2012.83

https://doi.org/10.3389/fsurg.2024.1332421

Epidemiology


Feature Details
Incidence Rare
Age Middle-aged adults (40–60 years)
Sex Slight male predominance
Sites Pleura, meninges, retroperitoneum, pelvis, orbit, soft tissue

Clinical Features