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

Abstract

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 > 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.

Keywords: Embolization; Giant tumors; Solitary fibrous tumor of the pleura (SFTP); Surgical treatment.

Figure 1

Giant solitary fibrous tumor of the pleura CT-scan (coronal view): pre-surgical assessment (A); post-surgical view (B).

Figure 2

Giant solitary fibrous tumor of the pleura: Surgical excision (A); Surgical specimen removed (B); H&E Staining, Original Magnification × 200 (C); Immunochemistry CD34 staining, Original Magnification × 200 (D).