Solitary Fibrous Tumor of Uterine Cervix - A Rare Entity Mimicking Clinically as Carcinoma Cervix

Q: How did the patient initially present, and what were the key clinical suspicions?

A 47-year-old woman presented with abnormal uterine bleeding for three months and occasional dysmenorrhea, with abnormal bleeding from a bulky cervix on examination. Clinical diagnosis of carcinoma was suspected, and colposcopy with biopsy revealed focal severe dysplasia.

Sep 30, 2026

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Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms originating from mesenchymal tissue, first described in the pleura. Extrapleural cases are reported, but SFT of the uterine cervix is exceptionally uncommon, with only a few cases in Indian and western literature. Preoperative definitive diagnosis is difficult; immunohistochemistry is crucial. This case report describes a 47-year-old woman with abnormal uterine bleeding, initially suspected as carcinoma clinically and dysplasia on biopsy. Ultimately, immunohistochemical findings confirm SFT.

LanguageEnglish

CategoryHealthcare

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Abstract

Keywords

Introduction

Case Report

Clinical Presentation

Imaging and Procedures

Histopathology

Immunohistochemistry

Discussion

Case Report Solitary Fibrous Tumor of Uterine Cervix: A Rare Entity Mimicking Clinically as Carcinoma Cervix Abstract Solitary fibrous tumors (SFTs) are a rare spindle cell neoplasm arising from mesenchymal cells. It was first described in the pleura. There are numerous reports that document their extrapleural locations. SFT involving the cervix is extremely rare and only a handful of cases have been reported in Indian and western literature. Previously, it was thought that SFT tumor cells differentiated from mesothelial cells into fibroblasts. With the advent of immunohistochemistry, it is revealed that tumor cells in SFT lack mesothelial characteristics but express CD34 and Bcl‑2, suggesting that the tumor originates from mesenchymal tissue. Preoperative definitive diagnosis of SFT cervix is difficult. Keywords: Cervix, immunohistochemistry, solitary fibrous, tumor Shirish Sahebrao Chandanwale, Akshi Raj, Madhuri Singh, Namit Gupta Department of Pathology, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India Introduction Solitary fibrous tumor (SFT) is a rare mesenchymal tumor with an incidence rate of 1–2 per million. It was characterized first in pleura. It has been reported at many other sites, commonly within peritoneum involving either visceral organs or abdominal and pelvic wall and deeper soft tissues of extremities, head and neck. [1‑3] SFT can occur in the female genital tract (FGT), most commonly in vulva followed by uterine corpus and infrequent at other locations.[4,5] SFT involving cervix is extremely rare and handful of cases has been reported in Indian and western literature.[4‑6] Preoperative definitive diagnosis of SFT cervix is difficult. Wereport a case of SFT of the uterine cervix in 47‑year‑old female who presented with abnormal uterine bleeding. Case Report A 47‑year‑old female presented with abnormal uterine bleeding for 3 months with passage of blood clots 7 days ago. She gave history of occasional dysmenorrhea. She was having two children aged 15 years and 12 years. She had menopause 1 year back before presentation. On routine laboratory test, she had mild anemia. There This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. For reprints [contact:](contact: WKHLRPMedknow_reprints@wolterskluwer.com)[ WKHLRPMedknow_reprints@wolterskluwer.com](contact: WKHLRPMedknow_reprints@wolterskluwer.com) were no significant findings on abdominal examination. Ultrasonography of abdomen and pelvis revealed Grade 1 fatty liver. On gynecological examination, cervix was bulky. A firm lesion was felt in cervix which bleed on touch. Clinical diagnosis of carcinoma was suspected. Colposcopy with biopsy revealed focal severe dysplasia of cervix. Magnetic resonance imaging abdomen and pelvis was done. Uterus was anteverted, normal in size with endometrial thickness was of 7 mm. Myometrium showed normal intensity. Both the ovaries were normal. Cervix was bulky and showed multiloculated solid cystic lesion measuring 1.5 cm × 2.8 cm × 2 cm involving the posterior part of the cervix [Figure 1a] . Intervening hypointense septae were seen in the lesion. The possibility of a neoplastic lesion was suggested. Considering age, clinical symptoms, and radiological findings hysterectomy was done. A specimen of radical hysterectomy with bilateral adnexa was sent for histopathology examination. Grossly cervix was bulky, and the wall of the cervix was thick and on cut section, it was greyish white. An ill‑defined grey white lesion measuring 1.6 cm × 2.8 cm was seen in the cervix [Figure 1b] . Uterine corpus, both the ovaries and fallopian tubes were grossly normal. How to cite this article: Chandanwale SS, Raj A, Singh M, Gup

FAQs

Why is preoperative definitive diagnosis of SFT of the cervix difficult?

SFT of the cervix is extremely rare and clinically mimics carcinoma. Imaging and initial biopsy findings may suggest neoplastic disease, making definitive identification challenging before histopathology and immunohistochemistry.

Which immunohistochemical markers support the diagnosis of solitary fibrous tumor in this case?

Tumor and endothelial cells show strong diffuse positivity for CD34 and Bcl-2. The tumor cells are negative for CD99, Vimentin, and Desmin, with a Ki-67 index reported as <1%.

How did the patient initially present, and what were the key clinical suspicions?

A 47-year-old woman presented with abnormal uterine bleeding for three months and occasional dysmenorrhea, with abnormal bleeding from a bulky cervix on examination. Clinical diagnosis of carcinoma was suspected, and colposcopy with biopsy revealed focal severe dysplasia.

Sep 30, 2026

Uploaded by ahduag