Solitary Fibrous Tumors of the Pleura: An Analysis of 110 Patients Treated in a Single Institution

Cardillo, Giuseppe; Carbone, Luigi; Carleo, Francesco; Masala, Nicola; Graziano, Paolo; Bray, Antonio; Martelli, Maria Paola

doi:10.1016/j.athoracsur.2009.07.026

Cited by 161 publications

(168 citation statements)

References 21 publications

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“…[3][4][5][6][7]10,18,[20][21][22] This may be due to the large number of intra-abdominal tumors in our cohort. Previous studies have suggested that tumor size 410 cm is predictive of poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model

et al. 2012

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Solitary fibrous tumor represents a spectrum of mesenchymal tumors, encompassing tumors previously termed hemangiopericytoma, which are classified as having intermediate biological potential (rarely metastasizing) in the 2002 World Health Organization classification scheme. Few series have reported on clinicopathological predictors with outcome data and formal statistical analysis in a large series of primary tumors as a single unified entity. Institutional pathology records were reviewed to identify primary solitary fibrous tumor cases, and histological sections and clinical records reviewed for canonical prognostic indicators, including patient age, tumor size, mitotic index, tumor cellularity, nuclear pleomorphism, and tumor necrosis. Patients (n ¼ 103) with resected primary solitary fibrous tumor were identified (excluding meningeal tumors). The most common sites of occurrence were abdomen and pleura; these tumors were larger than those occurring in the extremities, head and neck or trunk, but did not demonstrate significant outcome differences. Overall 5-and 10-year metastasis-free rates were 74 and 55%, respectively, while 5-and 10-year disease-specific survival rates were 89 and 73%. Patient age, tumor size, and mitotic index predicted both time to metastasis and disease-specific mortality, while necrosis predicted metastasis only. A risk stratification model based on age, size, and mitotic index clearly delineated patients at high risk for poor outcomes. While small tumors with low mitotic rates are highly unlikely to metastasize, large tumors Z15 cm, which occur in patients Z55 years, with mitotic figures Z4/10 high-power fields require close follow-up and have a high risk of both metastasis and death.

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Section: Discussionmentioning

confidence: 99%

Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model

et al. 2012

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“…Son consideradas lesiones benignas en general, pero poseen potencial maligno dependiendo de su histología 2 . Se manifiestan habitualmente por sintomatología respiratoria o compresiva 3 , asocián-dose en escasas ocasiones a síndromes paraneoplá-sicos tales como la hipoglicemia sintomática (Sín-drome de Doege-Potter, SDP) [4][5][6] y la osteoartropatía hipertrófica pulmonar (Síndrome de Pierre-MarieBamberg, SPMB) 7 . Presentamos el caso de un paciente con un TFSP que se manifestó con ambos síndromes paraneoplá-sicos, los cuales revirtieron tras el tratamiento quirúrgico.…”

Section: Introductionunclassified

“…No se ha demostrado mayor sobrevida con el uso de terapias adyuvantes, salvo cuando las resecciones han sido incompletas en las cuales podría observarse algún beneficio 4,11 . Respecto a los síndromes paraneoplásicos asociados, se ha reportado en la literatura resolución completa tras la resección tumoral, tal como en nuestro caso 18 .…”

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Tumor fibroso solitario de la pleura asociado a síndromes paraneoplásicos

et al. 2013

Rev Chil Cir

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Solitary fibrous tumor of pleura associated with paraneoplastic syndromes Introduction: Solitary fibrous tumors of pleura (SFTP) are occasionally associated with paraneoplastic syndromes such as hypoglycemia and diffuse skeletal hyperostosis. Clinical case: We report a 60 years old male presenting with episodes of disorientation and inappropriate behavior, along with cough and weight loss. On physical examination there was digital clubbing. A chest X ray showed a big tumor in the right hemithorax. Fasting blood glucose was 24 mg/dl and erythrocyte sedimentation rate was elevated. Large bone X rays showed hyperostosis. A needle biopsy of the tumor showed a SFTP. The tumor was excised and the final pathological diagnosis was a benign SFTP. Hypoglycemia subsided after surgery. After four months of follow up, finger clubbing was disappearing.

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“…This is because the ability of FNA to definitely rule out malignancy has not been demonstrated, and may not change the ultimate management plan of complete surgical excision [11].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Malignant Pathology and the Role of Trans-Thoracic Needle Biopsy in Management of Solitary Fibrous Tumors of the Pleura: A 30-Year Review of a Tertiary Care Center Patient Cohort

McGuire¹,

Villeneuve²,

Sekhon³

et al. 2016

OJTS

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Background: Solitary fibrous tumors of the pleura (SFTP) are rare neoplasms with unpredictable behavior. Lack of unifying criteria for benign or malignant SFTP has resulted in reports of SFTP exhibiting malignant behavior years after complete surgical resection (despite benign initial diagnosis). Additionally, the role of transthoracic needle biopsy in initial management of SFTP is unclear. Understanding predictors of malignancy identifies patients at unacceptably high risk for non-surgical primary therapy, and for recurrence despite complete surgical resection. Objectives: The primary objectives were to identify clinicopathological predictors of malignancy & recurrence in SFTP. The secondary aim was to determine the role of trans-thoracic needle biopsy in the management decision algorithm of SFTP. Methods: Retrospective chart review was conducted (Jan. 1983-Dec. 2013 58nign in 3 (75%) with recurrence. Clinicopathologic variables analyzed did not predict recurrent disease. IHC features did not differ between malignant & benign pathology significantly. Predictors of malignant pathology included: infiltrative cellular pattern (p = 0.042), nuclear crowding (p = 0.006), tumour necrosis (p < 0.001) and >4 mitoses/ 10 high power field (p < 0.003). Conclusion: Because numerous variables analyzed did not predict recurrent disease, long-term follow-up is warranted regardless of benign or malignant initial histology. Histologic not IHC features predicted malignant pathology. Trans-thoracic needle biopsy did identify malignant SFTP; however its main use should be to differentiate SFTP from other pleural neoplasms using IHC.

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Solitary Fibrous Tumors of the Pleura: An Analysis of 110 Patients Treated in a Single Institution

Cited by 161 publications

References 21 publications

Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model

Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model

Tumor fibroso solitario de la pleura asociado a síndromes paraneoplásicos

Predictors of Malignant Pathology and the Role of Trans-Thoracic Needle Biopsy in Management of Solitary Fibrous Tumors of the Pleura: A 30-Year Review of a Tertiary Care Center Patient Cohort

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