Giant solitary fibrous tumour of the pleura. Case report and review of the literature

Abstract

BackgroundSolitary fibrous tumours of the pleura (SFTP) are rare tumours. They are mostly benign. Only around 12% of them are malign ant. In the initial stage they are mostly asymptomatic and by growing they cause chest pain, irritating cough and dyspnoea on account of the pressure created on the surrounding structures. Rare giant tumours have compression symptoms on the mediastinal structures. The condition requires tiered diagnostic radiology. Preoperative biopsy is not successful in most cases. The therapy of choice is radical surgical tumour removal. Malignant or non-radically removed benign solitary fibrous tumours of the pleura additionally require neoadjuvant therapy.Case reportA 68-year old patient was hospitalized for giant solitary fibrous tumour of the pleura in the right pleural cavity. With its expansive growth the tumour caused the shift of the mediastinum by compressing the lower vena cava, right cardiac auricle as well as the intermediate and lower lobe bronchus. Due to cardiac inflow obstruction and right lung collapse, the patient’s life was endangered with signs of cardio-respiratory failure. After preoperative diagnostic radiology, the tumour was surgically removed. Postoperatively, the patient’s condition improved. No disease recurrence was diagnosed after a year.ConclusionsGiant solitary fibrous tumour of the pleura may cause serious and life-threatening conditions by causing compression of the pleural cavity with its expansive growth. Early diagnosis of the condition enables less aggressive as well as video-assisted thoracic surgery in patients with significantly better state of health. Large tumour surgeries in cardio-respiratory affected patients are highly risk-associated procedures.

Tumor fibroso solitario gigante de pleura en paciente joven

“…Tumor fibroso solitario gigante de pleura en paciente joven La clínica del tumor fibroso solitario de pleura (tfsp) gigante suele seguir un curso silente, cuyo hallazgo suele ser incidental en la radiografía o tomografía axial computarizada (tac) de tórax (1,2,9,14).…”

Extremely rare case of intravascular solitary fibrous tumour in the inferior vena cava with review of the literature

“…Clinical and imaging features also overlap. Therefore, the diagnosis of intravascular SFT is hardly achieved until surgical excision and pathological examination are carried out [31].…”

Giant solitary fibrous tumour of the pleura an unpredictable entity: case series and literature review

“…There have been reports of the use of angiography and preoperative percutaneous embolization to reduce intraoperative bleeding in cases of large tumours with major feeding vessels. 11,26 The use of adjuvant therapies has been reported in some cases, particularly in patients with malignant postoperative histology. 6,11 There are recent studies demonstrating the benefit of using both chemotherapeutic agents, such as antiangiogenic agents, 27 and radiotherapy 28 as adjuvant therapies.…”

“…11,26 The use of adjuvant therapies has been reported in some cases, particularly in patients with malignant postoperative histology. 6,11 There are recent studies demonstrating the benefit of using both chemotherapeutic agents, such as antiangiogenic agents, 27 and radiotherapy 28 as adjuvant therapies. To date, though, there is no consensus guideline on the use of these therapies in SFTP and their role has yet to be defined.…”

“…[8][9][10] In keeping with this more ubiquitous cell of origin, tumours with similar histological characteristics have been reported from a wide range of extrapleural tissues and organs including the liver, peritoneum, orbits, thyroid gland, breast, kidney and meninges. 3,11,12 SFTP are said to mostly follow an indolent course, with only around 15-20% fulfilling criteria for malignancy. 13 Here, we present five cases of SFTP highlighting the unpredictable nature of this disease and suggest that patients with this diagnosis should be managed with caution.…”