Laparoscopic Resection of a Mesorectal Solitary Fibrous Tumor: A Case Report and Review of the Literature.

Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm that can arise in various anatomical sites, whereas occurrence in the mesorectum is extremely uncommon. We report a case of mesorectal SFT successfully treated by laparoscopic resection and review the literature. A 62-year-old male was referred for further examination of a pelvic mass incidentally detected on computed tomography (CT). Imaging revealed a well-circumscribed 35-mm tumor located between the lower rectum and prostate without local invasion or distant metastasis. Although mesenchymal tumors such as gastrointestinal stromal tumor (GIST), schwannoma, and SFT were considered, a preoperative diagnosis could not be established due to biopsy difficulty and potential risks. Laparoscopic resection was performed for both diagnostic and therapeutic purposes. Histopathology revealed spindle cells in a patternless pattern with prominent vascularity. Immunohistochemistry showed positivity for CD34 and Bcl-2, and the morphological and immunophenotypic findings were considered consistent with SFT, although STAT6 immunostaining was not available. The postoperative course was uneventful, with no recurrence after six months of follow-up. In selected cases, minimally invasive surgery (MIS) enables complete tumor resection with organ preservation, while long-term follow-up remains essential due to the risk of late recurrence.