Integrated therapeutic approach to giant solitary fibrous tumor of the pleura: report of a case and review of the literature

Abstract

<jats:title>Abstract</jats:title><jats:p>The fibrous tumors of the pleura are rare primary tumors, accounting for 5% of malignant pleural neoplasms, which generally originate from sub-mesothelial mesenchymal tissue of the visceral pleura. These tumours generally exhibit clinical benign behavior although 12% of solitary fibrous tumors can be malignant and have worse outcomes. These tumors are considered “giant” when the lesion &gt; 15 cm. Surgical treatment is the best choice for both benign and malignant neoplasms. We retrospectively analyzed the main case series of giant fibrous tumors of the pleura. In addition we report our experience of a 76-year-old woman treated by pre-surgical embolization involving implantation of vascular plugs. Surgery was successfully carried out without complications; imaging and functional assessment 6 months post intervention demonstrated both the absence of recurrence and improvement of lung function parameters.</jats:p>

Predictors of behaviour in solitary fibrous tumours of the pleura surgically resected: Analysis of 107 patients

“…Some authors found a worst prognosis associated with tumours of giant dimension: in our series, we did not find tumour size as an independent prognostic factor. On the other hand, giant tumours are not so rare, because of the indolent slow growth, and may represent a surgical challenge needing larger pulmonary resections and sometimes preoperative embolization to reduce intraoperative bleeding . In our experience, giant tumours resulted more often associated with open surgery ( P = .003), origin from parietal pleura ( P = .011), intraoperative bleeding ( P > .001) and showed a trend toward longer hospitalization ( P = .065).…”

“…SFTP is a rare neoplasm that represents less than 5% of all pleural tumours. About 1800 cases are reported in the literature to date; whose 10%‐20% are malignant and only 5% are giant (>15 cm of maximum diameter) . Because of the rarity, only a few detailed studies dealing with 50 or more cases are presented in literature, confirming complete surgical resection as gold standard treatment, necessary to guarantee a long survival without any recurrence.…”

“…Between August 1972 and January 2018, 107 patients were surgically treated for SFTP in the two centers involved in this retrospective study (Padua University Hospital [n = 82] and Venice‐Mestre L'Angelo Hospital [n = 25]). As stated by literature, solitary fibrous tumours of the pleuras (SFTPs) were defined as giant when diameter was greater than 15 cm …”

“…Solitary fibrous tumour of the pleura (SFTP) represents a rare clinical entity. About 1800 cases are reported in literature to date; whose 10%‐20% are malignant and only 5% are giant (>15 cm of maximum diameter) . Gold standard therapy is complete surgical resection, necessary to guarantee a long survival without any recurrence.…”

Clinical diagnosis of malignant pleural mesothelioma

“…MPM symptoms are non-specific and may mimic other respiratory disease (12,13). The majority of patients with MPM present with breathlessness, chest pain, weight loss and fatigue (14,15).…”