Calcifying Fibrous Tumor Complicated by Empyema

Abstract

Calcifying fibrous tumor (CFT) is a rare, benign proliferation of fibroblasts and inflammatory cells that is non-invasive and usually arises in deep tissue structures. Due to its overall paucity, no accurate incidence has been reported yet. We understand this disease via a handful of case studies published in the medical literature, first of them being from 1988. Earlier known as 'pseudotumor', it was recently given its name due to the potential of recurrence and multifocal involvement. We describe the case of a 43-year-old Hispanic male who presented with a large symptomatic pleural-based mass which turned out to be CFT and was later complicated by empyema. Our aim is to increase awareness about this rare disease and throw light upon its benign nature, despite an alarming and suspicious appearance on imaging. Due to the large size of our patient's mass (largest reported yet), he needed extensive chest wall reconstruction, leading to complications requiring additional invasive procedures. This underscores the importance of early diagnosis and treatment which can reduce the need for aggressive surgical manipulation and avoid postoperative complications, thereby providing high-value care. Treating physicians should be mindful of this, in order to prompt early recognition to ensure effective patient care.

The Concrete Paltriness- Calcifying Fibrous Tumour

“…Imaging evaluation of calcifying fibrous tumour is concordant to histological composition of the neoplasm. Upon ultrasonography and computerized tomography (CT), a characteristic, well circumscribed mass with disseminated foci of calcification is denominated [7,8].…”

“…Endoscopic ultrasonography of calcifying fibrous tumour exhibits hypoechoic nodules with dispersed, hyperechoic areas concordant to calcification [8].…”

“…Computerized tomography depicts an enlarged, irregular tumefaction extending into abutting soft tissues. The neoplasm is associated with significant intrinsic calcification [7,8].…”

“…Magnetic resonance imaging (MRI) demonstrates an isoechoic signal intensity upon gadolinium-contrast enhanced T1 weighted imaging. Hypoechoic signal intensity is delineated upon T2 weighted imaging [7,8].…”

“…Initiation of therapy may be challenging with asymptomatic tumefaction, incidental tumour discernment or rapid tumour progression with consequent compression of adjacent organs or viscera. Calcifying fibrous tumour is appropriately alleviated with localized surgical excision [7,8].…”