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BackgroundWe explore the pattern of late recurrence (LR) in solitary fibrous tumor (SFT), focusing on histopathologic characteristics, clinical presentation and patients (pts) outcome.MethodsClinical records of all pts with confirmed pathologic diagnosis of SFT treated at our Institution from 2005 to 2011 were reviewed. We analysed the data of pts who relapsed ≥10 years after initial diagnosis.ResultsA total of 14 pts were identified. The primary site of origin was pleura (5 pts), pelvis (4 pts), head and neck (3 pts) and retroperitoneum (2 pts). Primary tumor was a typical SFT in 5 and a malignant SFT in 7 out of 12 pts whose tumor tissue was available for revision. The median time to first recurrence was 12 years (range 10–23). The first relapse was local in 11 cases, distant in 3. Five pts later developed distant metastases. Four out of 5 cases of typical SFT developed distant metastases in spite of their initial benign aspect. No patient was disease-free at the time of the analyses.ConclusionOur series suggests that LR can occur in SFT and some cases can behave aggressively even in the absence of any primary morphologic evidence of malignancy. A prolonged follow-up may be advisable.

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Surgical resection of PCWC leads to good oncological outcome. Wide surgical margins and G1 tumours predicted a better prognosis and a lower recurrence rate. The evolution of surgical technique and the introduction in clinical practice of new prosthetic materials allowed larger resections, and safe and anatomical reconstruction.

Repeat operation on patients with thymoma pleural recurrences is feasible and safe. It can produce satisfactory results in terms of overall survival and paraneoplastic syndrome control. Moreover, the multimodality treatment could improve the results of surgical treatment.