Solitary Fibrous Tumor of the Pleura With Abdominal Aortic Blood Supply

Addagatla, Kamal; Mamtani, Rishi; Babkowski, Robert; Ebright, Michael I.

doi:10.1016/j.athoracsur.2016.10.044

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Studies indicate that vascular pedicles from intercostal, internal mammary, or bronchial arteries may be found in up to 50% of SFTs [4] . Additionally, feeding vessels from the abdominal aorta [5] or celiac trunk [6] have been reported. The hypervascular nature of these masses can result in substantial hemorrhage, emphasizing the importance of preoperative evaluation of mass vascularity to facilitate bleeding-free resection.…”

Section: Discussionmentioning

confidence: 99%

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

Li,

Lu,

et al. 2024

Preprint

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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.

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Section: Discussionmentioning

confidence: 99%

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

Li,

Lu,

et al. 2024

Preprint

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show abstract

“…Studies indicate that vascular pedicles from intercostal, internal mammary, or bronchial arteries may be found in up to 50% of SFTs [ 4 ]. Additionally, feeding vessels from the abdominal aorta [ 5 ] or celiac trunk [ 6 ] have been reported. The hypervascular nature of these masses can result in substantial hemorrhage, emphasizing the importance of preoperative evaluation of mass vascularity to facilitate bleeding-free resection.…”

Section: Discussionmentioning

confidence: 99%

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

Li,

Lu,

et al. 2024

J Cardiothorac Surg

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Background Pleural solitary fibrous tumors (pSFTs) are rare mesenchymal pleural tumors with rich vascularity. Surgical resection is the cornerstone of pSFTs treatment, requiring careful preoperative imaging to delineate lesion extent and vascular supply including contrast-enhanced computed tomography and other examinations depending on its size and characteristics. Case presentation The patient was a 34-year-old female with a mass measuring approximately 67 × 42 × 65 mm in the left posterior mediastinum. 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 600 ml 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 firstly 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 and describe the related surgical procedures. This case highlights preoperative evaluation of mass vascularity based on contrast-enhanced computed tomography. When blood supply is challenging to clarify, angiography can offer additional details, especially for giant pSFTs. Despite this, thorough intraoperative exploration remains essential to detect unexpected vessels. Appropriate interventions should be customized based on the vascular origins and the surrounding anatomical structures.

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“…It has been reported that up to 50% of pSFTs have a vascular pedicle that might arise form intercostal, internal mammary, or bronchial arteries [ 51 , 52 ]. In addition, abdominal feeding vessels from the abdominal aorta or celiac tripod have been reported [ 53 , 54 , 55 ]. In a case report, Song [ 56 ] reported the surgical ligation of the feeding vessel via an anterior thoracotomy followed by pSFT resection through a lateral thoracotomy.…”

Section: Surgical Management In the Treatment Of Psftmentioning

confidence: 99%

Surgery for Solitary Fibrous Tumors of the Pleura: A Review of the Available Evidence

Bertoglio,

Querzoli,

Kestenholz

et al. 2023

Cancers

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Solitary fibrous tumors of the pleura (pSFT) are a relatively rare neoplasms that can arise from either visceral or parietal pleura and may have different aggressive biological behaviors. Surgery is well known to be the cornerstone of the treatment for pSFT. We reviewed the existing literature, focusing on the role of surgery in the management and treatment of pSFT. All English-written literature has been reviewed, focusing on those reporting on the perioperative management and postoperative outcomes. Surgery for pSFT is feasible and safe in all experiences reported in the literature, but surgical approaches and techniques may vary according to the tumor dimensions, localization, and surgeons’ skills. Long-term outcomes are good, with a 10-year overall survival rate of more than 70% in most of the reported experiences; on the other hand, recurrence may happen in up to 17% of cases, which occurs mainly in the first two years after surgery, but case reports suggest the need for a longer follow-up to assess the risk of late recurrence. Malignant histology and dimensions are the most recognized risk factors for recurrence. Recurrence might be operated on in select patients. Surgery is the treatment of choice in pSFT, but a radical resection and a careful postoperative follow-up should be carried out.

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Solitary Fibrous Tumor of the Pleura With Abdominal Aortic Blood Supply

Cited by 4 publications

References 7 publications

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

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

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

Surgery for Solitary Fibrous Tumors of the Pleura: A Review of the Available Evidence

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