Fibrous tumour of the pleura (SFTP): a proteiform disease. Clinical, histological and atypical radiological patterns selected among our cases

Abstract

First described by Klemperer and Rabin in 1931, solitary fibrous tumour of the pleura (SFTP) is a mesenchymal tumour that tends to involve the pleura, although it has also been described in other thoracic areas (mediastinum, pericardium and pulmonary parenchyma) and in extrathoracic sites (meninges, epiglottis, salivary glands, thyroid, kidneys and breast). SFTP usually presents as a peripheral mass abutting the pleural surface, to which it is attached by a broad base or, more frequently, by a pedicle that allows it to be mobile within the pleural cavity. A precise preoperative diagnosis can be arrived at with a cutting-needle biopsy, although most cases are diagnosed with postoperative histology and immunohistochemical analysis of the dissected sample. SFTP, owing to its large size or unusual locations (paraspinal, para-mediastinal, intra-fissural and intraparenchymal), can pose interpretation problems or, indeed, point towards a diagnosis of diseases of a totally different nature. We present some unusual radiographic and computed tomography (CT) images of large SFTP or SFTP located in atypical thoracic locations in patients who underwent surgical resection.

Retrospective analysis for thirty-nine patients with solitary fibrous tumor of pleura and review of the literature

“…By the aids of imageological examination, SFTP is relatively easy to diagnose when located in typical sites [12]. Rarely, diagnosis of SFTP may prove more challenging when the lesion is located in an unusual site.…”

Solitary fibrous tumors of the pleura

“…SFTP usually appears as a peripheral opacity with well defined borders [2,5,47] that predominantly affects the middle/inferior hemithorax [48], regardless of chest side ( Table 1). The chest computed tomography (CT) scan is the key examination, which more clearly shows the size and location of the tumor.…”

“…Changes in location and shape of the mass during respiration and with patient position constitute a pathognomonic signs in pedunculated tumors [2,47,48,52]. A concurrent pleural effusion (serous or serosanguineous) is reported in a range between 0 and 12% of cases (see Table 1).…”

Solitary fibrous tumor of the pleura: 3 case reports

“…Parts of these tumors tend to grow into massive injury before there is local compression symptoms. 2,3 They affect mainly adults between the sixth and seventh decades of life with the same distribution between men and women, and represent less than 5% of all tumors of the pleura. …”