Localized Fibrous Mesothelioma of Pleura Following External Ionizing Radiation Therapy

Bilbey, James H.; Müller, Néstor L.; Miller, Russell L.; Nelems, Bill

doi:10.1378/chest.94.6.1291

Cited by 43 publications

(15 citation statements)

References 8 publications

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“…Generally, there is no evidence of correlation with genetic predisposition for the tumour, and there is no relationship to the exposure to asbestos, tobacco or any other environmental agents, although there are only two case reports of patients with SFTP who were exposed to asbestos and one patient developed an SFTP following thoracic irradiation for the treatment of chest wall keloid [25,26].…”

Section: Historymentioning

confidence: 99%

Solitary fibrous tumours of the pleura

Arab

2011

European Journal of Cardio-Thoracic Surgery

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SummarySolitary fibrous tumours of the pleura are rare. They are mesenchymal in origin. Initially, they were described in the pleura, but lately they have been reported in many other sites. Although the majority of these tumours are benign, some of them are malignant. Their unpredictable clinical course is probably related to their histological and morphological characteristics. The benign tumours may remain unproblematic for several years before changing into a malignant form. In order to define more accurately the clinical behaviour, diagnosis, management and outcome of these rare tumours, we reviewed the literature with particular attention to clinical presentation, methods of diagnosis, treatment and outcome. Furthermore, a modified algorithm was proposed for the management of these tumours.

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Section: Historymentioning

confidence: 99%

Solitary fibrous tumours of the pleura

Arab

2011

European Journal of Cardio-Thoracic Surgery

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“…These tumors are rare, representing less than 5% of all pleural mesotheliomas (Theros et al 1977, as reported by Hill et al [41]), but are notable because, unlike malignant diffuse pleural mesotheliomas, there is no evidence of a causal link to asbestos exposure [41]. Two case reports support the association between exposure to therapeutic radiation and the development of mesothelioma [41,42].…”

Section: Radiotherapymentioning

confidence: 99%

Ionizing radiation: a risk factor for mesothelioma

Goodman

Nascarella

Valberg

2009

Cancer Causes Control

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In the majority of mesothelioma cases worldwide, asbestos is a likely causal factor, but several alternative factors, such as ionizing radiation, have been recognized. We reviewed ionizing-radiation evidence from epidemiology studies of (1) patients exposed to the diagnostic X-ray contrast medium "Thorotrast," (2) patients undergoing radiation therapy (i.e., to treat cancer), and (3) atomic energy workers chronically exposed to lower levels of radiation. The results from these populations are also supported by case reports of mesothelioma following therapeutic radiation. Statistically significant associations were found in many, but not all, epidemiology studies (particularly those of Thorotrast- and radiation-treated patients). Given the low mesothelioma rate in the general population, the consistently increased risk among these radiation-exposed individuals is noteworthy. Many studies were limited by the lack of a uniform manner in which mesothelioma was reported prior to introduction of a uniform classification system (ICD-10). Future studies that rely on ICD-10 should have greater power to detect an association. While the evidence falls short of a definitive causal link, considering studies in which statistical significance was achieved, the case reports, and the plausible mode of action, we conclude that the evidence is supportive of a causal link between ionizing radiation exposure and mesothelioma risk.

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“…Before the widespread acceptance of the term SFT, pleural SFT had been referred to using a number of other expressions, including fibrous mesothelioma, benign mesothelioma, localized mesothelioma, subpleural fibroma, and localized fibrous tumor of the pleura [2][3][4][5][6][7][8][9][10][11][12][13][14]. This was important in order to distinguish it from mesothelioma, which is clinically more aggressive.…”

Section: Introductionmentioning

confidence: 99%

Head and neck solitary fibrous tumors: a rare and challenging entity

Künzel¹,

Hainz²,

Ziebart³

et al. 2015

Eur Arch Otorhinolaryngol

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The objective of this study is to analyze the outcome of treatment for solitary fibrous tumors (SFTs) in the head and neck area. SFTs present as slow-growing masses, often with local compressive symptoms that are difficult to distinguish from other soft-tissue tumors. SFTs are commonly treated using local excision without adjuvant therapy. To date, only heterogeneous small series have been published, documenting the treatment results and outcome with these tumors. Retrospective study of patients with histopathologically confirmed SFT treated at two tertiary referral hospitals between 2004 and 2014. Eight men and four women with histologically confirmed SFT were identified in the records. Their age range was 37-82 years (mean 57.8 years). The mean follow-up period for eight patients was 6.75 years (range 1-24 years). Four patients were lost to follow-up. Sublocalizations were neck (n = 3), orbit (n = 2), paranasal sinus (n = 2), cheek (n = 2), hard palate (n = 1), parotid gland (n = 1), and tongue (n = 1). The first-line treatment for all of the tumors identified was surgical excision. In four cases, the surgical margins were narrow or unclear due to piecemeal resection in the paranasal sinus and orbit (n = 3) or a tumor location deep in the parapharyngeal space (n = 1). Recurrences developed in two of these cases (in the orbit and parapharyngeal space), and the other two patients were lost to follow-up. Radiotherapy and chemotherapy were not administered as first-line treatments. Overall, the local recurrence rate (n = 2/8) was 25 %. The disease-specific survival rate was 100 %. These results are consistent with the literature data and show that safe surgical excision, without opening of the tumor capsule, reduces the risk of local recurrence and leads to a favorable outcome. Tumors in the head and neck often represent a surgical challenge, and wide surgical margins are rarely possible due to the complex three-dimensional anatomic compartments in the region. Head and neck surgeons should therefore be aware that there is an increased risk of recurrence in these patients; tightly scheduled follow-up visits are mandatory for at least 10 years, if not longer. Radiotherapy only appears to be an option in patients with unresectable tumors or when wide surgical excision would cause severe functional morbidity.

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Localized Fibrous Mesothelioma of Pleura Following External Ionizing Radiation Therapy

Cited by 43 publications

References 8 publications

Solitary fibrous tumours of the pleura

Solitary fibrous tumours of the pleura

Ionizing radiation: a risk factor for mesothelioma

Head and neck solitary fibrous tumors: a rare and challenging entity

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