Giant Localized Solitary Fibrous Tumors of the Diaphragmatic Pleura: Report of Two Cases

Abstract

We report two cases, of 48- and 53-year-old women, with huge intrathoracic extrapulmonary tumors which originated from the diaphragm. In these cases the totally resected tumors were examined histologically and immunohistochemically, and based on these studies benign localized solitary fibrous tumors originating from the diaphragmatic pleura were diagnosed. We observed no recurrence in the long-term follow-up, which was necessary for these cases due to the tumors' unpredictable clinical behavior even when they were thought to be benign histologically. Because of the huge sizes of these tumors, originating from the diaphragmatic pleura with pedicles, and benign clinical outcome correlating with the histological examination, these cases are thought to be worthy of interest.

Successful diagnosis of diaphragmatic solitary fibrous tumor of the pleura by preoperative ultrasonography

“…[1][2][3] As diaphragmatic SFTPs originate from the pleura of the diaphragm, they usually develop as pedunculated tumors with a clear margin with their neighboring structures. 1-3 However, those characteristic fi ndings are not well documented by radiological images.…”

“…1 Preoperative diagnosis of diaphragmatic SFTP, a well-capsulated pedunculated tumor in the diaphragm, is diffi cult because its morphological features are not well detected by radiological examinations. [1][2][3] Ultrasonography (US) is less invasive and a handy examination, but little is known about its usefulness for differential diagnosis of diaphragmatic tumors. In this report we presented a case of diaphragmatic SFTP that was successfully diagnosed by US.…”

Solitary Fibrous Tumor of the Cervical Esophagus

“…About 700 cases of SFTs were described from 1942; in 85-90% of cases they arose from the pleura, but have also been described in other locations in the body, including the pelvic cavity, nasal cavity, pulmonary parenchyma, meninges, kidney, lung, mediastinum, retroperitoneum, temporal region, neck, groin, buttock, and thigh [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Tumor fibroso solitario de la pleura: Análisis de 41 casos

“…Fueron descritos inicialmente por Klemperer y Rabin en 1931 1 , y han recibido diversos nombres (mesotelioma benigno, fibroma subpleural, mesotelioma localizado, etc) hasta adquirir su nomenclatura actual. Hay evidencias ultraestructurales e inmunohistoquímicas tales como positividad a vimentina, y la no expresión de filamentos intermedios como citoqueratina y desmina 2,3 que han permitido concluir que estas lesiones no son de origen mesotelial, sino del tejido conectivo submesotelial [4][5][6][7][8][9][10][11] . Una característica constante es la ausencia de positividad para citoqueratinas, en contraste con la expresión constante de éstas en mesoteliomas sarcomatoides 5 .…”

“…Se han descrito tumores de este tipo en localizaciones extratorácicas como meninges, cavidad oral, globo ocular, mama, riñón, vejiga y otros [11][12][13][14][15] . También se ha descrito hipoglicemia en relación a ellos, lo que se debería a un excesivo consumo de glucosa por la neoplasia, a sustancias similares a la insulina o a la acción de inhibidores de la neoglucogénesis segregados por el tumor [5][6][7][9][10][11][13][14][15][16][17][18][19] . Se relaciona con osteoartropatía hipertrófica en aproximadamente un 20%, lo cual se debería a una anormal producción de ácido hialurónico por parte de las células tumorales que tiende a regresar con la resección del tumor [5][6][7][9][10][11]14,20 .…”