Recurrent solitary fibrous tumor of the pleura with malignant transformation: a case report

Abstract

We report a rare case of recurrent solitary fibrous tumor (SFT) of the pleura with suspicious malignant transformation. A 78-year-old man had undergone prior surgical resection of the primary and recurrent SFT tumors at 11 and 2 years before the current presentation. Although his primary tumor had a round shape and did not show invasive growth, the current recurrent tumor extended through the neural foramen and had an osteoclastic progression into the thoracic spine. A computed tomography (CT) guided needle biopsy was performed and the pathological diagnosis of the tumor was confirmed as the recurrence of SFT. Immunohistochemically, the MIB-1 proliferation index (Ki-67) of the primary tumor and the current tumor was 1.74 and 30.00%, respectively. These clinical and immunohistochemical findings were strongly suspected the malignant transformation of SFT from benign. He was treated with radiotherapy, and a response was observed.

Malignant progression of cerebellopontine angle solitary fibrous tumors following radiation: illustrative case

“…However, individual reports of malignant progression following radiotherapy such as that of Apra et al 10 call into question the efficacy of this treatment for tumor control and PFS. 7,11,12 SFTs are usually benign tumors with an indolent clinical course. 1 Whether radiation therapy could induce or accelerate the malignant progression could not be established in the literature.…”

“…However, individual reports of malignant progression following radiotherapy such as that of Apra et al 10 call into question the efficacy of this treatment for tumor control and PFS. 7 , 11 , 12 …”

“…However, it should be noted that the malignant progression usually takes a long time after treatment, ranging from 10 to 12 years. 10 , 11 Radiation therapy might be just one of the several mechanisms of provoking the malignant progression. This is quite evident from our case report as well because the progression was reported within 1.5 years of first surgery or 6 months of salvage radiosurgery.…”