Recurrent localized fibrous tumor of the pleura

Solitary fibrous tumour of the pleura arising in a pulmonary cavity

Solitary fibrous tumour of the pleura (SFTP) arising in a cavity is extremely rare. A 66-year-old Japanese male presented with an abnormal shadow on his chest X-ray. Chest computed tomography showed a cavity of approximately 18 mm in diameter between the upper and lower lobes that contained a solid nodule within. Under the thoracoscope, the peduncle cystic tumour was removed with sufficient surgical margin. Macroscopically, a tumour of about 15 mm in diameter arose in the cystic cavity. Immunohistochemical stains were positive for CD34, bcl-2, and signal transduction and activator of transcription 6 (STAT6) but negative for smooth muscle actin (SMA), desmin, and epithelial membrane antigen (EMA), and a diagnosis of SFTP was made. The patient remains well without recurrence or any complications at two and a half years after the operation. SFTP should be considered when a tumour arises in a cavity existing in an interlobar space. It is important to determine whether the tumour is pedunculated or sessile during surgery and to perform the appropriate surgical procedure.

Imaging of benign solitary fibrous tumor of the pleura: a pictorial essay

Solitary fibrous tumor of the pleura (SFTP) is a mesenchymal tumor that tends to involve the pleura, and is also described in other thoracic and extrathoracic sites. SFTP usually presents as a peripheral mass abutting the pleural surface, to which it is attached by a broad base or by a pedicle that allows it to be mobile. SFTPs exist in benign and malignant forms. A precise pre-operative diagnosis can be arrived at with a cutting-needle biopsy, although most cases are diagnosed with postoperative histology and immunohistochemical analysis. In this pictorial essay, we review a large series of cases, with emphasis on the radiographic appearance of these lesions and their findings from computed tomography, magnetic resonance imaging, ultrasonography and positron emission tomography.

Solitary fibrous tumors of the pleura presenting satellite tumors

A 29-year-old man presented with a mass in the left lower lung field on a chest radiograph obtained during a medical checkup. Computed tomography revealed a tumor adjacent to the diaphragm. A sessile tumor measuring 10.5 x 8.5 x 4.5 cm arising from the parietal pleura was resected. The tumor was accompanied by several little tumors on the nearby diaphragm. Pathologically, the major tumor consisted of typical spindle-shaped cells with myxoid degeneration. There was no increased cellularity, cellular pleomorphism, or a high mitotic count. In immunohistochemical studies, the spindle cells showed positive staining for CD34 and were negative for bcl-2. The smaller tumors also consisted of myxoid degeneration. We diagnosed benign solitary fibrous tumor of the pleura with satellite tumors. We must be aware of the possibility of satellite tumors when we treat patients with a benign solitary fibrous tumor.

Radical resection of a giant, invasive and symptomatic malignant Solitary Fibrous Tumour (SFT) of the pleura

Solitary Fibrous Tumours (SFTs) of the pleura are rare neoplasms, with unpredictable biological behaviour. Although usually benign, malignant SFTs are described, and they are often associated with large, necrotic and locally invasive tumours. Radical resection represents the treatment of choice in all cases; recurrences are uncommon, and redo-surgery should be considered. The case of a giant, invasive, radically resected malignant SFT, is described. The role of postoperative radiotherapy, to reduce the risk of recurrence, is also discussed.