Pancreatic Solitary Fibrous Tumor: A Common Tumor Occurring in a Rare Location

Qiang Zeng; Guo-ping Li; Yu-peng Chen; Fang-ling Song; Feng Gao; Jie-zhen Li

doi:10.12659/AJCR.950097

31 March 2026 : Case report China

Pancreatic Solitary Fibrous Tumor: A Common Tumor Occurring in a Rare Location

Challenging differential diagnosis, Rare coexistence of disease or pathology

Qiang Zeng^{ABCDEF 1,2}, Guo-ping Li^{BC 1,2}, Yu-peng Chen^{BC 1,2}, Fang-ling Song^{BC 1,3}, Feng Gao^{AFG 1,2}, Jie-zhen Li^{ABCDFG 4*}

DOI: 10.12659/AJCR.950097

Am J Case Rep 2026; 27:e950097

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Table 1 Summary of primary pancreatic SFTs reported in the literature.

Reference	Age (years)/sex	Clinical/imaging-based diagnosis	Symptom	Pancreatic site	Maximum tumor diameter (cm)
Lüttges et al []²	50/F	NET	Incidental	Body	5.5
Chatti et al []³	41/M	NET	Abdominal pain	Body	13
Gardini et al []⁴	62/F	NET	Abdominal pain	Head	3
Miyamoto et al []⁵	41/F	NET	Abdominal pain	Neck	2
Kwon et al []⁶	54/M	NET or GIST	Incidental	Body	7.6
Srinivasan et al []⁷	78/F	NET	Back pain, weight loss	Body	5
Chetty et al []⁸	67/F	NET	Incidental	Uncinate process	2.6
Ishiwatari et al []⁹	58/F	NET	Incidental	Head	3
Sugawara et al []¹⁰	55/F	NA	Incidental	Head	7
Santos et al []¹¹	40/F	NA	Incidental	Body	3
Azadi et al []¹²	57/M	NA	Incidental	Tail	3.1
Yamanashi et al []¹³	50/M	NEC	Incidental	Tail	10
Tasdemir et al []¹⁴	24/F	Mesenchymal tumor	Epigastric pain	Head	18.5
van der Vorst et al []¹⁵	67/F	NET	Abdominal pain	Uncinate process	2.8
Chen et al []¹⁶	49/F	NET	Abdominal pain	Head	13
Kim et al []¹⁷	52/F	NET	Incidental	Tail	2
Hwang et al []¹⁸	53/F	NET	Incidental	Head	5.2
Baxter et al []¹⁹	58/F	NET or GIST	Abdominal pain	Head	3.5
Estrella et al []²⁰	52/F	NET	Jaundice	Head	15
Han et al []²¹	77/F	NET	Jaundice	Head	1.5
Murakami et al []²²	82/M	NET	Hypertension, hyper-cortisolism, hypokalemia, edema	Tail	6
Spasevska et al []²³	47/M	Cystadenocarcinoma	Epigastric pain, jaundice	Head	3.5
Zhang et al []²⁴	43/M	Castleman’s disease	Abdominal discomfort	Body/tail	4
	46/M	Chronic pancreatitis	Abdominal pain	Body/tail	4
	63/M	NET	Incidental	Body/tail	3
Paramythiotis et al []²⁵	55/M	NET	Incidental	Body	3.6
D’Amico FE et al []²⁶	52/M	NET	Incidental	Body	2
Clare et al []²⁷	39/F	NET	Incidental	Head	2.2
Oana et al []²⁸	73/M	NET or GIST	Abdominal pain	Head	6.5
Sheng et al []²⁹	1/M	NA	Obstructive jaundice	Head	2
Geng et al []³⁰	48/M	NA	Hypo-glycemia	Body	6.5
Afzal et al []³¹	43/M	NET or GIST	Incidental	Head	12.7
Li et al []³²	61/M	GIST	Abdominal pain	Body	11
Taguchi et al []³³	60/M	NET or GIST	Palpable mass	Head	8
Liu et al []³⁴	54/F	Benign or low-grade malignant pancreatic tumor	Incidental	Head	3.1
Yavas et al []³⁵	72/M	NET	Abdominal pain	Head	5
	76/F	NET	Back pain	Tail	4
	65/F	NET	Incidental	Head	4
	56/M	Cystic mass with solid component/cystic malignancies	Incidental	Head	3.7
	36/F	Complex cystic mass/inflammatory conditions, SPN, mucinous neoplasms	Abdominal pain	Tail	2.7
	55/F	Solid hypervascular mass/nonductal neoplasms	Abdominal pain	Head	3
	57M	Solid hypervascular mass	Incidental	Head	0.9
	56/M	Solid hypervascular mass	Abdominal pain	Head	15
	70/M	NA	NA	Tail	13
Wang et al []³⁶	54/M	NET	Incidental	Body	3
	53/F	NET	Incidental	Head	2.8
	69/F	NET	Incidental	Body/tail	3.1

Lüttges et al []²	Moderate pleomorphism, no mitosis or necrosis	CD34, bcl-2, CD99, vimentin	SFT	DP	Alive/20
Chatti et al []³	Necrosis, no atypia or mitosis	CD34, bcl-2, CD99, CD117, SMA, vimentin	SFT	DP	Death on postoperative day 3
Gardini et al []⁴	NA	CD34, bcl-2, CD99, SMA, vimentin	SFT	PD	Alive/16
Miyamoto et al []⁵	No atypia, mitosis, or necrosis	CD34, bcl-2	SFT	Enucleation	Alive/7
Kwon et al []⁶	No atypia	CD34, CD99, vimentin	SFT	MS	Alive/88
Srinivasan et al []⁷	No atypia or necrosis, <1 mitosis/10 HPF	CD34, bcl-2, CD99, vimentin	SFT	DP	Alive/7
Chetty et al []⁸	No atypia, mitosis, or necrosis	CD34, bcl-2, CD99	SFT	PD	Alive/6
Ishiwatari et al []⁹	Low atypia, focal necrosis, no mitosis	CD34, bcl-2	SFT	PD	Alive/42
Sugawara et al []¹⁰	NA	CD34	SFT	PD	NA
Santos et al []¹¹	No atypia, mitosis, or necrosis	CD34, beta-catenin	SFT	Enucleation	NA
Azadi et al []¹²	No atypia or necrosis, low mitotic index	CD34, bcl-2	SFT	DP	NA
Yamanashi et al []¹³	Intrapancreatic metastases, mild atypia, >2 mitoses/HPF, necrosis, hypercellularity	CD34, bcl-2, vimentin	SFT	DP	Alive/Local recurrence 21 months after surgery
Tasdemir et al []¹⁴	1–2 mitoses/10 HPF	CD34, focal bcl-2, vimentin, beta-catenin	SFT	Enucleation	Alive/3
van der Vorst et al []¹⁵	No atypia, mitosis, or necrosis	CD34, bcl-2, CD99	SFT	Enucleation	NA
Chen et al []¹⁶	Necrosis	CD34, bcl-2, CD68, SMA	SFT	PD	Alive/30
Kim et al []¹⁷	No atypia	CD34, bcl-2	SFT	DP	Alive/12
Hwang et al []¹⁸	NA	CD34, bcl-2, CD99, CD10, SMA, ER, PR	SFT	PHR	Alive/6
Baxter et al []¹⁹	No mitosis or necrosis	CD34, bcl-2, beta-catenin, CD99	SFT	LPD	Alive/24
Estrella et al []²⁰	Sarcomatous component, nuclear pleomorphism, marked cellularity, up to 17 mitoses/10 HPF, necrosis	CD34, bcl-2; p53 and p16 in malignant areas	Malignant SFT	LPD	Alive/40
Han et al []²¹	No atypia, mitosis, or necrosis	CD34, bcl-2	SFT	Biopsy	Alive/10
Murakami et al []²²	NA	STAT6, CD34, bcl-2, NSE, ACTH	SFT	DP	Death 4 months after surgery due to sepsis
Spasevska et al []²³	Minimal pleomorphism and atypia, 1–2 mitoses/10 HPF, no necrosis	CD34, bcl-2, CD99, vimentin, beta-catenin, SMA	SFT	LPD	Death after postoperative week 1
Zhang et al []²⁴	NA	CD34	SFT	DP	Alive/NA
	NA	CD34, bcl-2, CD99, SMA, CD68	SFT	DP	Alive/NA
	Marked focal atypia, necrosis, obvious mitosis, hypercellularity	CD34, CD99, CD117, SMA, NSE, vimentin	Malignant SFT	DP	Death after postoperative fourth month due to multiple metastases
Paramythiotis et al []²⁵	Rare mitosis, necrosis	CD34, CD99, bcl-2, vimentin, S100	SFT	DP	Alive/12
D’Amico FE et al []²⁶	1 mitosis/10 HPF	STAT6, CD34	SFT	DP	Alive/24
Clare et al []²⁷	6 mitoses/10 HPF, no necrosis	STAT6, CD34, bcl-2	Malignant SFT	PD	Alive/1
Oana et al []²⁸	No mitosis or necrosis	CD34, bcl-2	SFT	Enucleation	Alive/36
Sheng et al []²⁹	Duodenal invasion, mild to moderate pleomorphism, 2–5 mitoses/10 HPF in hypercellular area, no necrosis	CD34, SMA, vimentin	SFT with low-grade malignancy	DP	Alive/12
Geng et al []³⁰	Liver metastases, pleomorphism, 4–5 mitoses/10 HPF, focal necrosis	STAT6, CD34, bcl-2, CD31, D2–40	Malignant SFT	DP	Alive/6
Afzal et al []³¹	Moderate pleomorphism in hypercellular area, no increased mitosis, no necrosis	STAT6, CD34, bcl-2, CD99, CD117	SFT	PD	NA
Li et al []³²	Splenic vein invasion, 25 mitoses/10 HPF in hypercellular area	STAT6, CD34, cytokeratin, EMA	Malignant SFT	DP	Alive/4
Taguchi et al []³³	Venous invasion, duodenal invasion, 12 mitoses/10 HPF, necrosis, hypercellularity	STAT6, CD34, bcl-2, CKp, vimentin	Malignant SFT	PD	Alive/12
Liu et al []³⁴	No atypia or necrosis, 0–2 mitoses/10 HPF	STAT6, CD34, CD99	SFT	LDPPHRt	Alive/6
Yavas et al []³⁵	Low atypia, no necrosis, 3 mitoses/10 HPF	STAT6, bcl-2, vimentin	SFT	PD	Alive/17
	Moderate pleomorphism, no mitosis or necrosis	STAT6, bcl-2, SMA, ER, inhibin	SFT	DP	Alive/138
	Low atypia, no mitosis or necrosis	STAT6, CD34	SFT	PD	Alive/42
	Low atypia, no mitosis or necrosis	STAT6, CD34	SFT	PD	Alive/47
	Low atypia, no mitosis or necrosis	STAT6, CD34, SMA	SFT	DP	Alive/189
	Low atypia, no mitosis or necrosis	STAT6, CD34, calponin	SFT	PD	Alive/107
	Low atypia, no mitosis or necrosis	CD34, PAX8, PAX2	SFT	PD	Alive/3
	Low atypia, focal necrosis, 1 mitosis/10 HPF	CD34, bcl-2	SFT	PD	Alive/62
	Low atypia, no necrosis, <1 mitosis/10 HPF	STAT6, CD34, bcl-2, CD99	SFT	DP	NA
Wang et al []³⁶	No atypia or necrosis	STAT6, CD34, bcl-2, CD99, vimentin	SFT	DP	Alive/3
	Local infiltration. No atypia, mitosis, or necrosis	STAT6, CD34, bcl-2, vimentin	SFT	PD	Alive/14
	Interstitial collagen fiber hyperplasia. No atypia, mitosis, or necrosis	STAT6, CD34, bcl-2, CD99, vimentin	SFT	DP	Alive/16
SFT – solitary fibrous tumor; M – Male; F – Female; NA – not available; NEC – neuroendocrine carcinoma; NET – neuroendocrine tumor; GIST – gastrointestinal stromal tumor; SPN – solid pseudopapillary neoplasm; HPF – high-power field; SMA – smooth muscle actin; EMA – epithelial membrane antigen; ER – estrogen receptor; PR – progesterone receptor; ACTH – adrenocorticotropic hormone; NSE – neuron-specific enolase; CKp – cytokeratin pan; LDPPHRt – Laparoscopic duodenum-preserving pancreatic head resection; MS – median segmentectomy; PHR – Pancreatic head resection; LPD – laparoscopic pancreaticoduodenectomy; TP – total pancreatectomy; PD – pancreaticoduodenectomy; DP – distal pancreatectomy.

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Pancreatic Solitary Fibrous Tumor: A Common Tumor Occurring in a Rare Location

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