Солитарная фиброзная опухоль предстательной железы и семенного пузырька в сочетании с аденокарциномой предстательной железы

Трушкин Р.Н., Огнерубов Н.А., Соколов С.А., Исаев Т.К., Горшков С.И., Бережная Э.Э., Соколов А.А. Солитарная фиброзная опухоль предстательной железы и семенного пузырька в сочетании с аденокарциномой предстательной железы. Consilium Medicum. 2025;27(7):385–390. DOI: 10.26442/20751753.2025.7.203328

© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.

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Trushkin RN, Ognerubov NA, Sokolov SA, Isaev TK, Gorshkov SI, Berezhnaya EE, Sokolov AA. Prostate and seminal vesicle solitary fibrous tumor combined with prostate adenocarcinoma. Case report. Consilium Medicum. 2025;27(7):385–390. DOI: 10.26442/20751753.2025.7.203328

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Аннотация

Солитарная фиброзная опухоль – крайне редкое фибропластическое новообразование мезенхимальной природы, которое имеет неопределенный злокачественный потенциал с промежуточным биологическим поведением. Чаще всего локализуется в плевре. Экстраплевральные поражения мочеполовой системы, включая предстательную железу (ПЖ) и особенно семенные пузырьки, встречаются в единичных случаях. Специфические клинические проявления при локализации в ПЖ отсутствуют, может имитировать аденому ПЖ с явлениями инфравезикальной обструкции. При локализации опухоли в семенных пузырьках чаще наблюдались локальные симптомы: гематурия, дизурия, гемоспермия. Основа медицинской визуализации – магнитно-резонансная томография с контрастированием и комбинированная позитронно-эмиссионная и рентгеновская компьютерная томография с различными трейсерами. Для подтверждения диагноза необходима биопсия с последующим гистологическим и иммуногистохимическим исследованием с определением экспрессии в опухолевой ткани CD34 и STAT6. Основной метод лечения солитарной фиброзной опухоли – хирургический, в объеме иссечения с отступом края 1–2 см. В статье представлен уникальный клинический случай первичной множественности синхронных солитарных фиброзных опухолей ПЖ и семенного пузырька в сочетании с раком ПЖ. Такой случай в доступной отечественной и зарубежной литературе описан впервые. Своевременная диагностика этих новообразований позволяет выбрать рациональную тактику персонализированного лечения.

Ключевые слова: солитарная фиброзная опухоль, предстательная железа, семенной пузырек, рак предстательной железы, магнитно-резонансная томография, иммуногистохимия, лечение

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Solitary fibrous tumor is an extremely rare fibroplastic mesenchymal neoplasm with an uncertain malignant potential and intermediate biological behavior. It is most often localized in the pleura. Extrapleural lesions of the genitourinary system, including the prostate gland and especially the seminal vesicles, occur in anecdotal cases. There are no specific clinical manifestations of tumor localized in the prostate gland; it can mimic prostate adenoma with infravesical obstruction. With the localization of the tumor in the seminal vesicles, local symptoms are more common: hematuria, dysuria, and hemospermia. The basis of medical imaging is contrast-enhanced magnetic resonance imaging and combined positron emission and X-ray computed tomography with various tracers. To confirm the diagnosis, a biopsy followed by histological and immunohistochemical examination with determination of CD34 and STAT6 expression in the tumor tissue is required. The main therapy for a solitary fibrous tumor is surgical excision with a resection margin of 1–2 cm. The article presents a unique clinical case of a primary multiple synchronous solitary fibrous tumor of the prostate and seminal vesicle combined with prostate cancer. This is the first such case described in the available Russian and international literature. Timely diagnosis of these neoplasms enables a rational approach to personalized treatment.

Keywords: solitary fibrous tumor, prostate gland, seminal vesicle, prostate cancer, magnetic resonance imaging, immunohistochemistry, treatment

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Список литературы

1. Klemperer P, Coleman B.R. Primary neoplasm of the pleura: a report of five cases. Arch Pathol. 1931;11:385-412.
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6. Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: A summary. Neuro-Oncol. 2021;23:1231-51.
7. Cranshaw IM, Gikas PD, Fisher C, et al. Clinical outcomes of extra-thoracic solitary fibrous tumours. Eur J Surg Oncol. 2009;35(9):994-8. DOI:10.1016/j.ejso.2009.02.015
8. Haas RL, Walraven I, Lecointe-Artzner E, et al. Extrameningeal solitary fibrous tumors – Surgery alone or surgery plus perioperative radiotherapy: A retrospective study from the global solitary fibrous tumor initiative in collaboration with the Sarcoma Patients EuroNet. Cancer. 2020;126:3002-12.
9. Peng Y, Jiang Y, Ding S, et al. Solitary fibrous tumors in prostate: a case report with review of the literature. Aging Male. 2022;1(25):219-27. DOI: 10.1080/13685538.2022.2110232
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20. Yang T, Zhu R, Guo Z, et al. Solitary Fibrous Tumor of the Prostate Shown on FAPI PET/CT. Clin Nucl Med. 2023;48(6):530-1.
21. Badawy M, Nada A, Crim J, et al. Solitary fibrous tumors: Clinical and imaging features from head to toe. Eur J Radiol. 2022;146:110053. DOI:10.1016/j.ejrad.2021.110053
22. Demicco EG, Harms P, Patel R, et al. Extensive Survey of STAT6 Expression in a Large Series of Mesenchymal Tumors. Am J Clin Pathol. 2015;143:672-82.
23. Koelsche C, Schweizer L, Renner M, et al. Nuclear relocation of STAT6 reliably predicts NAB2-STAT6 fusion for the diagnosis of solitary fibrous tumour. Histopathology. 2014;65:613-22.
24. Crocetti D, Sapienza P, Lamazza A, et al. Tumor of the Seminal Vesicle: A Systematic Literature Review and Case Presentation. In Vivo. 2021;35(4):1945-50. DOI:10.21873/invivo.12461
25. Wahlstedt E, Zhou C, Strup S, et al. Locally advanced solitary fibrous tumour of the prostate. BMJ Case Rep. 2023;16(10).
26. Schirosi L, Lantuejoul S, Cavazza A, et al. Pleuro-pulmonary Solitary Fibrous Tumors: A Clinicopathologic, Immunohistochemical, and Molecular Study of 88 Cases Confirming the Prognostic Value of de Perrot Staging System and p53 Expression, and Evaluating the Role of c-kit, BRAF, PDGFRs (α/β), c-met, and EGFR. Am J Surg Pathol. 2008;32:1627-42.
27. de Bernardi A, Dufresne A, Mishellany I, et al. Therapeutic Options for Solitary Fibrous Tumor: Antiangiogenic Therapy and Beyond. Cancers. 2022;14:1064. DOI:10.3390/cancers14041064
28. Marcal LP, Surabhi VR, Ramani NS, et al. Mesenchymal neoplasms of the prostate and seminal vesicles: spectrum of disease with radiologic-pathologic correlation. Radiographics. 2022;2(42):417-32. DOI:10.1148/rg.210084
29. Фирсов К.А, Салимзянов Ф.И, Халмурзаев О.А., и др. Солитарная фиброзная опухоль предстательной железы: клинический случай и обзор литературы. Онкоурология. 2024;20(2):116-21 [Firsov KA, Salimzyanov FI, Khalmurzaev OA, et al. Solitary fibrous tumor of the prostate: clinical case and literature review. Cancer Urology. 2024;20(2):116-21 (in Russian)]. DOI:10.17650/1726-9776-2024-20-2-116-121
30. Wang Q, Yu D. X, Xie D, et al. Images – A case of total laparoscopic resection of a giant solitary fibrous tumor of the seminal vesicle: A rare tumor that causes frequent micturition and abdominal pain. Can Urol Assoc J. 2019;13(11):E38790. DOI:10.5489/cuaj.5782
31. Kaiqiang H, Dongbin W, Xin W, et al. Solitary fibrous tumor of the seminal vesicle: a case report. Chinese Journal of Urology. 2021;42(05)393-4. DOI:10.3760/cma.j.cn112330-20200520-00404
32. Shikha G, Renu M, Urmi M, et al. Solitary fibrous tumor of the seminal vesicle. J Cancer Res Therap. 2023;19(5):1412-43. DOI:10.4103/jcrt.jcrt_525_22
33. Zhao Q, Dong A, Ye H, et al. Intense PSMA Uptake in Solitary Fibrous Tumor of the Seminal Vesicle. Clin Nucl Med. 2024;49(6):594-6. DOI:10.1097/RLU.0000000000005195
34. Musyoki FN, Nahal A, Powell TI. Solitary fibrous tumor: an update on the spectrum of extrapleural manifestations. Skeletal Radiol. 2012;41(1):5-13. DOI:10.1007/s00256-010-1032-z
35. Schweizer L, Koelsche C, Sahm L, et al. Meningeal hemangiopericytoma and solitary fibrous tumors carry the NAB2-STAT6 fusion and can be diagnosed by nuclear expression of STAT6 protein. Acta Neuropathol. 2013;125:651-8.
36. Zhao R, Shan Y, Zou L, et al. Solitary fibrous tumor of the seminal vesicle: A case report. Medicine (Baltimore). 2019;98(9):146.

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1. Klemperer P, Coleman B.R. Primary neoplasm of the pleura: a report of five cases. Arch Pathol. 1931;11:385-412.
2. de Pinieux G, Karanian M, Le Loarer F, et al. Nationwide incidence of sarcomas and connective tissue tumors of intermediate malignancy over four years using an expert pathology review network. PLoS One. 2021;16:e0246958.
3. Kinslow CJ, Wang TJC. Incidence of extrameningeal solitary fibrous tumors. Cancer. 2020;126:4067.
4. Goodlad JR, Fletcher CDM. Solitary fibrous tumour arising at unusual sites: Analysis of a series. Histopathology. 1991;19:515-22.
5. Ronchi A, Cozzolino I, Zito Marino F, et al. Extrapleural solitary fibrous tumor: A distinct entity from pleural solitary fibrous tumor. An update on clinical, molecular and diagnostic features. Ann Diagn Pathol. 2018;34:142-50.
6. Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: A summary. Neuro-Oncol. 2021;23:1231-51.
7. Cranshaw IM, Gikas PD, Fisher C, et al. Clinical outcomes of extra-thoracic solitary fibrous tumours. Eur J Surg Oncol. 2009;35(9):994-8. DOI:10.1016/j.ejso.2009.02.015
8. Haas RL, Walraven I, Lecointe-Artzner E, et al. Extrameningeal solitary fibrous tumors – Surgery alone or surgery plus perioperative radiotherapy: A retrospective study from the global solitary fibrous tumor initiative in collaboration with the Sarcoma Patients EuroNet. Cancer. 2020;126:3002-12.
9. Peng Y, Jiang Y, Ding S, et al. Solitary fibrous tumors in prostate: a case report with review of the literature. Aging Male. 2022;1(25):219-27. DOI: 10.1080/13685538.2022.2110232
10. Ye X, Yu H, Sun B, et al. Malignant solitary fibrous tumor of the seminal vesicle: a case report and review of the literature. BMC Urol. 2020;25:119. DOI:10.1186/s12894-025-01815-6
11. Tallini G, Dorfman H, Brys P, et al. Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group. J Pathol. 2002;196(2):194-203.
12. Kim JM, Choi YL, Kim YJ, Park HK. Comparison and evaluation of risk factors for meningeal, pleural, and extrapleural solitary fibrous tumors: A clinicopathological study of 92 cases confirmed by STAT6 immunohistochemical staining. Pathol Res Pract. 2017;213:619-25.
13. Ronchi A, Cozzolino I, Zito Marino F, et al. Extrapleural solitary fibrous tumor: A distinct entity from pleural solitary fibrous tumor. An update on clinical, molecular and diagnostic features. Ann Diagn Pathol. 2018;34:142-50. DOI:10.1016/j.anndiagpath.2018.01.004
14. Khandelwal A, Virmani V, Amin MS, et al. Radiology-pathology conference: malignant solitary fibrous tumor of the seminal vesicle. Clin Imaging. 2013;37(2):409-13. DOI:10.1016/j.clinimag.2012.04.027
15. Wignall OJ, Moskovic EC, Thway K, et al. Solitary Fibrous Tumors of the Soft Tissues: Review of the Imaging and Clinical Features With Histopathologic Correlation. Am J Roentgenol. 2010;195:W55-62.
16. Steigen SE, Schaeffer DF, West RB, et al. Expression of insulin-like growth factor 2 in mesenchymal neoplasms. Mod Pathol. 2009;22:914-21.
17. Ryabov AB, Pikin OV, Abu-Khaidar OB. Solitary fibrous malignant tumor of the pleura with associated hypoglycemia: a case report. Siberian journal of oncology. 2020;19(2):147-52 (in Russian). DOI:10.21294/1814-4861-2020-19-2-147-152
18. Kallen ME, Hornick JL. The 2020 WHO Classification: What’s New in Soft Tissue Tumor Pathology? Am J Surg Pathol. 2021;45:e1-e23.
19. Bansal R, Shirkhoda L, O'Connell R, et al. Incidental solitary fibrous tumor involving the seminal vesicle: A case report. Radiology Case Reports. 2024;19(4):1654-57. DOI:10.1016/j.radcr.2024.01.046
20. Yang T, Zhu R, Guo Z, et al. Solitary Fibrous Tumor of the Prostate Shown on FAPI PET/CT. Clin Nucl Med. 2023;48(6):530-1.
21. Badawy M, Nada A, Crim J, et al. Solitary fibrous tumors: Clinical and imaging features from head to toe. Eur J Radiol. 2022;146:110053. DOI:10.1016/j.ejrad.2021.110053
22. Demicco EG, Harms P, Patel R, et al. Extensive Survey of STAT6 Expression in a Large Series of Mesenchymal Tumors. Am J Clin Pathol. 2015;143:672-82.
23. Koelsche C, Schweizer L, Renner M, et al. Nuclear relocation of STAT6 reliably predicts NAB2-STAT6 fusion for the diagnosis of solitary fibrous tumour. Histopathology. 2014;65:613-22.
24. Crocetti D, Sapienza P, Lamazza A, et al. Tumor of the Seminal Vesicle: A Systematic Literature Review and Case Presentation. In Vivo. 2021;35(4):1945-50. DOI:10.21873/invivo.12461
25. Wahlstedt E, Zhou C, Strup S, et al. Locally advanced solitary fibrous tumour of the prostate. BMJ Case Rep. 2023;16(10).
26. Schirosi L, Lantuejoul S, Cavazza A, et al. Pleuro-pulmonary Solitary Fibrous Tumors: A Clinicopathologic, Immunohistochemical, and Molecular Study of 88 Cases Confirming the Prognostic Value of de Perrot Staging System and p53 Expression, and Evaluating the Role of c-kit, BRAF, PDGFRs (α/β), c-met, and EGFR. Am J Surg Pathol. 2008;32:1627-42.
27. de Bernardi A, Dufresne A, Mishellany I, et al. Therapeutic Options for Solitary Fibrous Tumor: Antiangiogenic Therapy and Beyond. Cancers. 2022;14:1064. DOI:10.3390/cancers14041064
28. Marcal LP, Surabhi VR, Ramani NS, et al. Mesenchymal neoplasms of the prostate and seminal vesicles: spectrum of disease with radiologic-pathologic correlation. Radiographics. 2022;2(42):417-32. DOI:10.1148/rg.210084
29. Firsov KA, Salimzyanov FI, Khalmurzaev OA, et al. Solitary fibrous tumor of the prostate: clinical case and literature review. Cancer Urology. 2024;20(2):116-21 (in Russian). DOI:10.17650/1726-9776-2024-20-2-116-121
30. Wang Q, Yu D. X, Xie D, et al. Images – A case of total laparoscopic resection of a giant solitary fibrous tumor of the seminal vesicle: A rare tumor that causes frequent micturition and abdominal pain. Can Urol Assoc J. 2019;13(11):E38790. DOI:10.5489/cuaj.5782
31. Kaiqiang H, Dongbin W, Xin W, et al. Solitary fibrous tumor of the seminal vesicle: a case report. Chinese Journal of Urology. 2021;42(05)393-4. DOI:10.3760/cma.j.cn112330-20200520-00404
32. Shikha G, Renu M, Urmi M, et al. Solitary fibrous tumor of the seminal vesicle. J Cancer Res Therap. 2023;19(5):1412-43. DOI:10.4103/jcrt.jcrt_525_22
33. Zhao Q, Dong A, Ye H, et al. Intense PSMA Uptake in Solitary Fibrous Tumor of the Seminal Vesicle. Clin Nucl Med. 2024;49(6):594-6. DOI:10.1097/RLU.0000000000005195
34. Musyoki FN, Nahal A, Powell TI. Solitary fibrous tumor: an update on the spectrum of extrapleural manifestations. Skeletal Radiol. 2012;41(1):5-13. DOI:10.1007/s00256-010-1032-z
35. Schweizer L, Koelsche C, Sahm L, et al. Meningeal hemangiopericytoma and solitary fibrous tumors carry the NAB2-STAT6 fusion and can be diagnosed by nuclear expression of STAT6 protein. Acta Neuropathol. 2013;125:651-8.
36. Zhao R, Shan Y, Zou L, et al. Solitary fibrous tumor of the seminal vesicle: A case report. Medicine (Baltimore). 2019;98(9):146.

Авторы

Р.Н. Трушкин^1,2, Н.А. Огнерубов*³, С.А. Соколов², Т.К. Исаев², С.И. Горшков², Э.Э. Бережная², А.А. Соколов⁴

¹ФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы», Москва, Россия;
²ГБУЗ «Городская клиническая больница №52» Департамента здравоохранения г. Москвы, Москва, Россия;
³ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
⁴ФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента РФ, Москва, Россия
*ognerubov_n.a@mail.ru

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Ruslan N. Trushkin^1,2, Nikolai A. Ognerubov*³, Sergey A. Sokolov², Teymur K. Isaev², Stanislav I. Gorshkov², Elvira E. Berezhnaya², Aleksandr A. Sokolov⁴

¹People’s Friendship University of Russia named after Patrice Lumumba, Moscow, Russia;
²City Clinical Hospital №52, Moscow, Russia;
³Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
⁴Central Clinical Hospital with Polyclinic, Moscow, Russia
*ognerubov_n.a@mail.ru

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