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Case Reports
. 2021 Feb;111(2):e85-e88.
doi: 10.1016/j.athoracsur.2020.05.100. Epub 2020 Jul 17.

Multifocal Calcifying Fibrous Tumor at Seven Intrathoracic Sites in One Patient

Moises Hernandez  1 , Grace Lin  2 , Yu Zhang  1 , Ataollah Rajabnejad  1 , Francesca Balistrieri  1 , Patricia Thistlethwaite  3
Affiliations
Case Reports

Multifocal Calcifying Fibrous Tumor at Seven Intrathoracic Sites in One Patient

Moises Hernandez et al. Ann Thorac Surg. 2021 Feb.

Abstract

Calcifying fibrous tumors are rare lesions that occur throughout the body. A 35-year-old man presented with exertional dyspnea. Computed tomography showed a polypoid mass abutting pericardium, diaphragm, and left chest wall, and a pleural-based lesion adjacent to T12. Thoracoscopy revealed a large mass with diaphragmatic stalk, two pleural-based nodules, and four diaphragmatic nodules. Pathologic analysis of resected lesions showed calcifying fibrous tumors. Three lesions contained heterogenous mutations associated with this tumor type. The patient is disease free 1 year later. Calcifying fibrous tumors should be recognized as rare multifocal pleural and diaphragmatic-based tumors. Complete resection leads to excellent survival for patients with this uncommon disease.

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Figures

Figure 1.
Figure 1.
(A) CT imaging showing a large multi-lobulated mass abutting the lateral chest wall, diaphragm, and pericardium, and (B) a smaller lesion adjacent to the T12 vertebral body (red arrow), with large mass seen in (A) (blue arrow).
Figure 2.
Figure 2.
(A) Video-assisted thoracoscopic intraoperative view of the large multi-lobulated mass with single stalk to the diaphragm. (B) resected large multi-lobulated calcified mass, (C) two resected contiguous, but separate nodules overlying the T12 vertebral body (middle tumors in image) and four resected tumorlets from the diaphragm (right and left tumors in image).
Figure 3.
Figure 3.
Microscopic features of the largest mass shows bland spindle cells, densely hyalinized collagen in storiform and whorled arrangement, psammomatous calcifications, and patchy lymphoplasmacytic infiltrates. Hematoxylin and eosin stain, (40X, A) (200X, B) (400X, C). (D) Trichrome staining of dense fibrotic stroma in the largest mass (magnification 400X).
See this image and copyright information in PMC

References

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