{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:26:00Z","timestamp":1787117160866,"version":"build-2736575974"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>We report a rare case of malignant solitary fibrous tumor (MSFT) in the cervical region presenting with aggressive bone destruction and lung metastasis in a 54-year-old HIV-infected male. The patient, who was on long-term antiretroviral therapy (EFV\u00a0+\u00a03TC+TDF), presented with a 5-month history of a progressively enlarging mass in the posterior neck (approx. 10.0\u00a0cm x 8.0\u00a0cm x 4.0\u00a0cm) accompanied by radiating pain in the right upper limb. Initial imaging revealed an osteolytic, destructive lesion involving the C3-C5 vertebrae and multiple solid pulmonary nodules, suspicious for malignancy. Preliminary biopsy and immunohistochemistry initially suggested a mesenchymal malignant tumor, possibly a BCOR-altered sarcoma. Following a multidisciplinary team (MDT) consultation and according to the 2024 CSCO guidelines for bone and soft tissue tumors, the patient received two cycles of neoadjuvant chemotherapy (Epirubicin 30mg D1-D3 and Ifosfamide 2g D1-D5). Subsequent surgical resection was performed, and definitive histopathological and immunohistochemical analysis of the postoperative specimen confirmed MSFT (STAT6+, CD34+, P53 mutant type ~85%, and Ki-67 ~60%). This case emphasizes the diagnostic challenge of differentiating rare spindle cell sarcomas in HIV-infected patients; high-grade MSFT can mimic other aggressive sarcomas, and comprehensive postoperative pathological evaluation, especially STAT6 staining, is essential for definitive diagnosis and tailoring oncological management.<\/jats:p>","DOI":"10.3389\/fonc.2026.1880093","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:41:30Z","timestamp":1787114490000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary malignant solitary fibrous tumor of the neck in an HIV-positive patient: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Jing","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Medical Imaging, Yunnan Provincial Hospital of Infectious Disease","place":["Kunming, Yunnan, 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