Solitary Fibrous Tumor of the Greater Omentum with Intratumoral Infarction: A Case Report

Solitary fibrous tumors (SFTs) are rare mesenchymal tumors with rich vascularity that rarely arise from the greater omentum. Many cases of SFT are asymptomatic and discovered incidentally; however, symptomatic cases may occur when complications such as intratumoral infarction develop. We report a case of an SFT originating from the greater omentum, complicated by intratumoral infarction.

A 71-year-old woman presented to the emergency department with a 2-day history of worsening abdominal pain. Laboratory testing revealed elevated inflammatory markers, with a white blood cell count of 17.0 × 10³/μL and C-reactive protein level of 11.34 mg/dL. Contrast-enhanced CT demonstrated an approximately 80-mm, relatively homogeneous abdominal mass with poor internal enhancement. MRI showed uniformly low signal intensity on T1-weighted images and a heterogeneous mixture of intermediate and low signal intensity on T2-weighted images. Diffusion-weighted imaging revealed hyperintensity corresponding to the intermediate T2-signal area, whereas the T2-low-signal regions remained hypointense. Conservative management was initiated, resulting in a gradual improvement of abdominal pain and inflammatory markers. On hospital day 8, laparotomy was performed, and the tumor, arising from and continuous with the greater omentum, was completely resected. Pathology demonstrated intratumoral infarction, and immunohistochemical findings confirmed the diagnosis of an SFT. The postoperative course was uneventful, and no recurrence was observed.

SFTs arising from the greater omentum may develop intratumoral infarction, presenting with acute abdominal pain and inflammatory responses. Cross-sectional imaging modalities, such as CT and MRI, can assist in identifying this uncommon pathological condition.