Resection of pleural solitary fibrous tumors with distinct feeding vessels arising from the descending aorta: a case report

Abstract

Background Pleural solitary fibrous tumors (pSFTs) are rare mesenchymal pleural tumors with rich vascularity Surgical resection is the cornerstone of pSFTs treatment, requiring meticulous preoperative imaging to delineate lesion extent and vascular supply. Case presentation: The patient was a 34-year-old female with a mass measuring approximately 67×42×65 mm in the left posterior mediastinum. Computed tomography (CT) scans revealed the feeding vessels of the mass closely associated to the descending aorta. Following comprehensive preoperative assessments, thoracoscopic surgery was performed. Intraoperatively, the mass demonstrated rich vascularity. Two veins originating from the abdominal cavity entered the lower pole, one converged from the superior pole, draining into the brachiocephalic vein. Additionally, two arteries arose directly from the descending aorta, while several veins drained into the intercostal veins. In response to unexpected intraoperative vascular findings, vascular clips and silk threads were used to ligate them. Subsequently, the tumor was successfully dissected, with approximately 600ml of blood loss recorded during the 4-hour surgery. The patient exhibited a satisfactory postoperative recovery, and follow-up spanning over six months revealed no indications of recurrence or metastasis. Conclusions We present a case of successful resection of a pSFT in a 34-year-old woman with a distinct feeding vessel arising from the descending aorta, which is firstly reported. This case highlights preoperative evaluation of mass vascularity and proper application of preoperative angiography and embolization.