Solitary fibrous pleural tumor. A rare and challenging case

Fatimi, Saulat Hasnain; Inam, Hina; Chagan, Farida Karim; Choudry, Usama Khalid

doi:10.1016/j.ijscr.2019.12.020

Cited by 5 publications

(16 citation statements)

References 20 publications

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“…For patients with a large tumor or extensive adhesions, thoracotomy is often used, and in case of incomplete resection or recurrence, the secondary operation may be needed (51,52). Originated from the pleural wall, extrapleural resection can be carried out without removing the chest wall (53), and patients with pericardial cavity involvement may need cardiopulmonary bypass support (54). Preoperative percutaneous embolization has been reported to reduce the risk of intraoperative bleeding significantly; however, SFTP embolization may lead to a rare potential life-threatening complication (55).…”

Section: Discussionmentioning

confidence: 99%

Rapidly growing solitary fibrous tumors of the pleura: a case report and review of the literature

Zuo¹,

Zhou²,

Sun³

et al. 2020

Ann Transl Med

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A solitary fibrous tumor (SFT) is a rare spindle cell tumor-derived from mesenchymal cells. It may be linked to the fusion of the NAB2-STAT6 gene caused by 12q chromosome rearrangement. It can occur in the connective tissue of any part of the body; however, it is most common in the pleura. Solitary fibrous tumors of the pleura (SFTP) are a persistent painless mass with slow growth. With the increase of the tumor, there will be corresponding compression symptoms. Pleural effusion is rare, and the cytology of pleural effusion is mostly negative. Occasionally, SFTP can induce paraneoplastic syndrome, distant metastasis, and malignant transformation. Lung function may have mild to moderate restrictive ventilation dysfunction. CT is a crucial method for the clinical diagnosis of SFTP. The histopathological features of SFTP are the coexistence of sparse and dense areas. CD34, CD99, Bcl-2, and vimentin are the most valuable immunohistochemical markers.The positive expression rate of STAT6 in benign SFT was even 100%. Adhesion or unclear boundary with surrounding tissues, pleural effusion or calcification, tumors with a maximum diameter greater than 10 cm, invasive growth, uneven density, metastasis or recurrence, paraneoplastic syndrome, moderate to severe cell heterogeneity, high Ki67 proliferation index, and low STAT6 expression suggest SFTP may be a malignant tumor. Gene analysis on next generation sequencing may help reveal the mutation characteristics of SFTP. Complete tumor resection is the gold standard of SFTP. Resectability is the most important prognostic factor. Age, size, mitosis, and necrosis are considered risk stratification factors for prognosis. Fortunately, 80% of SFTP are benign and have anexcellentprognosis but need long-term follow-up.We report a case of rapidly growing tumor with pleural effusion within 9 months, who was surgically treated and is currently under follow-up. And the literature is reviewed.

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Section: Discussionmentioning

confidence: 99%

Rapidly growing solitary fibrous tumors of the pleura: a case report and review of the literature

Zuo¹,

Zhou²,

Sun³

et al. 2020

Ann Transl Med

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“…Los tumores solitarios fibrosos (TSF), neoplasias raras mesenquimales con diferenciación fibroblástica (1), conforman menos del 5 % de los tumores pleurales y son usualmente benignos (2-6), presentándose malignidad en un 12 % a 22 % de los casos (1,2,7), incluso con presencia de metástasis [5]. La relación de tumores benignos a malignos es de 7:1 (2,7).…”

Section: Discussionunclassified

Tumor fibroso solitario de mediastino anterior adherido a pericardio. Reporte de un caso

Giraldo

2022

rev. colomb. neumol.

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Se presenta el caso de un paciente de 82 años, con tumor intratorácico de crecimiento rápido, con aumento progresivo de la disnea, antecedentes de enfermedad coronaria y baja función cardíaca, obesidad y síndrome de apnea de sueño, quien fue sometido a toracotomía y a quien se le diagnosticó un tumor solitario fibroso de la pleura, tumor de muy baja frecuencia, adherido en forma sésil al pericardio, lo cual lo hace aún menos frecuente. Se hace una revisión general de las posibilidades terapéuticas, el diagnóstico histológico y por inmunohistoquímica, así como los criterios de benignidad y malignidad para este tipo de tumor, que son en su mayoría de buen pronóstico.

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“…Thus, preoperative diagnosis may not always provide a complete picture of the tumour and may be inaccurate. 11 For example, a previously published report showed that the accuracy of CT-guided transthoracic fine needle aspiration biopsy (FNAB) ranges in levels below 50%. 4 The patient in the present case had four pathology results.…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 Preoperative diagnosis, such as imaging examination and even biopsy can be inaccurate. 11 Surgery is the best treatment option, serving as both a diagnostic and therapeutic procedure, and postoperative pathology remains the gold standard for diagnosis. 12 The role of preoperative and postoperative treatments are still unclear, including those involving patients with locally advanced or metastatic SFT.…”

Section: Introductionmentioning

confidence: 99%

Locally advanced malignant solitary fibrous tumour successfully treated with conversion chemotherapy, operation and postoperative radiotherapy: a case report

Liu

Chen

et al. 2021

J Int Med Res

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Preoperative diagnosis of solitary fibrous tumour (SFT) may not provide a complete tumour picture and may be inaccurate. There is no standard treatment for locally advanced or metastasised malignant SFT (MSFT). Here, the case of a 17-year-old male patient with final pathology diagnosis of MSFT is reported. Preoperative biopsy pathology results suggested an Ewing sarcoma that was positive for CD99 antigen, vimentin, friend leukaemia integration 1 transcription factor, apoptosis regulator Bcl-2, and synaptophysin; and negative for CD34 antigen, S-100 protein (S-100), smooth muscle antigen, cytokeratin, and Wilms tumour 1 associated protein. The Ki67 positive rate was 8%, so the patient initially received eight cycles of conversion chemotherapy (vincristine, etoposide, ifosfamide and pirarubicin for one cycle, and vincristine, doxorubicin, and cyclophosphamide/ifosfamide and etoposide for 7 cycles in total). The tumour shrunk significantly and was surgically removed. The final pathology diagnosis was MSFT that was positive for CD99 and signal transducer and activator of transcription 6, and negative for CD34, tumour protein 63, S-100, desmin, and epithelial membrane antigen. Fluorescence in situ hybridization showed no gene translocation in EWS RNA binding protein 1, SS18 subunit of BAF chromatin remodelling complex or FUS RNA binding protein. The patient finally accepted adjuvant radiotherapy of 5600 cGy. Disease-free survival has been > 1 year, with no recurrence or metastasis detected to date. MSFT is rare and treatment for locally advanced or metastatic MSFT remains controversial. The efficacy of the present therapeutic strategy requires further research.

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Solitary fibrous pleural tumor. A rare and challenging case

Cited by 5 publications

References 20 publications

Rapidly growing solitary fibrous tumors of the pleura: a case report and review of the literature

Rapidly growing solitary fibrous tumors of the pleura: a case report and review of the literature

Tumor fibroso solitario de mediastino anterior adherido a pericardio. Reporte de un caso

Locally advanced malignant solitary fibrous tumour successfully treated with conversion chemotherapy, operation and postoperative radiotherapy: a case report

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