Solitary fibrous tumors of the pleura

Cardillo, Giuseppe; Lococo, Filippo; Carleo, Francesco; Martelli, Maria Paola

doi:10.1097/mcp.0b013e328352f696

Cited by 85 publications

(119 citation statements)

References 59 publications

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“…SFTPs are not associated with asbestos exposure or cigarette smoking. 1 SFTPs may be detected asymptomatically, although 50% to 60% of the patients may complain of cough, chest pain, hemoptysis, and dyspnea, especially when the lesions are large. Systemic symptoms, such as hypoglycemia (5%) or hypertrophic osteoarthropathy (4% to 35%), are infrequently encountered, but are considered as suggestive of SFTP, 8,9 and may occur more commonly with larger lesions.…”

Section: Clinical Presentationmentioning

confidence: 96%

“…Occasionally, SFTPs may invade the adjacent lung parenchyma, and may even arise from an extrapleural location, including the pericardium, or even from extrathoracic locations, such as the peritoneum. [1][2][3][4] Areas of hemorrhage, cystic change, or frank necrosis may be encountered, and, when extensive enough, may be associated with a higher rate of recurrence, prompting the designation of malignant SFTP.…”

Section: Gross Pathology and Histopathologymentioning

confidence: 97%

“…Frankly malignant SFTPs may metastasize to the liver, the central nervous system, the spleen, the peritoneum, the adrenal gland, the gastrointestinal tract, the kidney, or the bone. 1 MRI of SFTP often shows a peripheral lesion, again with broad chest wall contact forming obtuse angles with the chest wall, with heterogeneous signal intensity, with foci of increased and decreased T1 and T2 signal, the latter suggesting fibrotic areas within the tumor. Intense enhancement after intravenous gadolinium administration is commonly encountered in patients with SFTP.…”

Section: Imaging Manifestationsmentioning

confidence: 98%

“…16 Treatment SFTPs are typically surgically resected, 17 and complete tumor excision is the most important factor for predicting a favorable clinical outcome for histologically malignant tumors. 1,18 The prognosis for SFTP patients is good, with overall 5-year survival rates ranging from 79% to 100%. 1 SFTPs may also be treated with either preoperative or postoperative adjuvant chemotherapy (doxorubicin and ifosfamide) or radiotherapy, typically when the tumor cannot be resected completely, and few data are available regarding the efficacy of these forms of treatment.…”

Section: Imaging Manifestationsmentioning

confidence: 99%

“…1,18 The prognosis for SFTP patients is good, with overall 5-year survival rates ranging from 79% to 100%. 1 SFTPs may also be treated with either preoperative or postoperative adjuvant chemotherapy (doxorubicin and ifosfamide) or radiotherapy, typically when the tumor cannot be resected completely, and few data are available regarding the efficacy of these forms of treatment. SFTPs may recur after surgical resection, typically within the ipsilateral hemithorax and often within 24 months of the initial surgical resection, although late recurrences have been reported.…”

Section: Imaging Manifestationsmentioning

confidence: 99%

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A Thoracic Mass Discovered at Abdominal Imaging

Panse

Jensen²,

Cummings³

et al. 2015

Clinical Pulmonary Medicine

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Solitary fibrous tumor of the pleura (SFTP) is a rare primary pleural neoplasm arising from the submesothelial mesenchymal cell layer just beneath the mesothelial lining of the pleura. SFTPs consist of spindle cells embedded within variable amounts of connective tissue, typically staining positive for vimentin and antibodies to CD34. SFTPs are often attached to pleural surfaces through a pedicle. Histopathologic criteria for malignancy include high mitotic counts ( > 4 mitoses per 10 high-power fields), pleomorphism, hypercellularity, tumor giant cells, necrosis, and hemorrhage. Chest radiography in patients with SFTP shows a peripheral mass displaying characteristics suggesting an extraparenchymal location: obtuse angles with the chest wall associated with a circumscribed border on one side of the lesion with an indistinct, "fading" margin on the opposite side of the lesion. Crosssectional imaging findings of SFTP include a variably sized mass contacting the chest wall or the diaphragm, showing enhancement after intravenous contrast administration. Calcification and effusion are uncommon. Magnetic resonance imaging may show decreased T1 and T2 signal, suggesting the fibrous nature of SFTPs, and also typically shows intense, heterogeneous, intravenous contrast enhancement. The treatment of choice for SFTP is wide surgical resection. Key Words: fibrous tumor of pleura, tumor, neoplasm, focal fibrous tumor of the pleura (Clin Pulm Med 2015;22:261-264)T he incidental detection of abnormalities in imaging studies is a common occurrence, not only with thoracic imaging examinations, but at the margins of neck and abdominal crosssectional imaging studies. Many such findings are of no, or at most minor, clinical significance, but occasionally an incidentally detected abnormality is large and compelling enough that its discovery, even for patients with few or no respiratory complaints, mandates immediate further evaluation. The most common incidental abnormalities detected in nonthoracic imaging studies that, by protocol design, necessarily image some of the thorax (such as cross-sectional imaging of the neck or the abdomen) are found within the lungs, but unexpected abnormalities may also be encountered in extraparenchymal locations. Proper localization of the abnormal finding is the key first step to generating appropriate differential considerations and developing an approach to establishing a diagnosis for the patient. CASE REPORTA 66-year-old nonsmoking woman with a history of hypothyroidism on replacement therapy, and a medical history of pancreatitis, presented with complaints of abdominal pain and loose stools beginning over a decade earlier, accompanied by epigastric pain. These complaints were attributed to cholecystitis, for which endoscopic retrograde cholangiopancreatography was performed, but this procedure precipitated an episode of pancreatitis. During the endoscopic retrograde cholangiopancreatography procedure, her common bile duct was found to be narrowed and several stones were extracted, with the plac...

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Section: Clinical Presentationmentioning

confidence: 96%

Section: Gross Pathology and Histopathologymentioning

confidence: 97%

Section: Imaging Manifestationsmentioning

confidence: 98%

Section: Imaging Manifestationsmentioning

confidence: 99%

Section: Imaging Manifestationsmentioning

confidence: 99%

See 3 more Smart Citations

A Thoracic Mass Discovered at Abdominal Imaging

Panse

Jensen²,

Cummings³

et al. 2015

Clinical Pulmonary Medicine

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Predictors of behaviour in solitary fibrous tumours of the pleura surgically resected: Analysis of 107 patients

Bellini

Marulli

Breda

et al. 2019

Journal of Surgical Oncology

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Objectives: Gold standard therapy for solitary fibrous tumour of the pleura is complete surgical resection. Aims of this retrospective study are to evaluate oncological and surgical outcomes and to verify the clinical reliability of prognostic scores presented in literature. Methods: Study population: 107 patients surgically treated between 1972 and 2018. Male/female ratio: 1/2.45; median age at surgery: 60 years (range, 19-80); peduncle lesions 69.8%; visceral pleura origin 72.9%; benign histology 73.8%; median diameter 8 cm (range 1 to 35, 27 cases giant [≥15 cm]).Results: After a median follow up of 7 years, 12 patients had recurrence. By multivariate analysis, malignant histology (P = .03; HR, 4.17; 95% CI, 1.15-15.06), origin from parietal pleura (P = .03; HR, 3.90; 95% CI, 1.08-14.09), England (P = .002; HR, 1.98; 95% CI, 1.28-3.07), Diebold (P = .008; HR, 1.96; 95% CI, 1.20-3.22) and Tapias (P = .003; HR, 1.75; 95% CI, 1.20-2.53) scores were found independent significant predictors of relapse. Giant tumours were associated with open surgery (P = .003), origin from parietal pleura (P = .011) and intraoperative bleeding (P > .001).Overall 10-year disease-free survival (DFS) rate was 81%. Predictors of worst DFS were parietal pleura origin (P = .002), malignant histology (P = .006) and all the prognostic scores.Conclusions: Malignant histology and origin from parietal pleura were significant predictors of tumour recurrence and worst DFS. The use of current scoring systems can help to predict clinical behaviour. Patients with higher risk of relapse can benefit from closer follow up, prolonged over 10 years. K E Y W O R D S fibroma, prognostic factors, prognostic scores, recurrence, solitary fibrous tumour Abbreviations: CT, computed tomography; DFS, disease free survival; FDG, fluorodeoxyglucose; HPF, high-power fields; PET-CT, positron emission tomography-CT; SCLC, small cell lung cancer; SFTP, solitary fibrous tumour of the pleura; SFTPs, solitary fibrous tumours of the pleura.Alice Bellini and Giuseppe Marulli equally contributed to the major design, planning and writing of the paper.

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Non-mesothelial Tumors of the Pleura

Weissferdt

2020

Diagnostic Thoracic Pathology

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Solitary fibrous tumors of the pleura

Cited by 85 publications

References 59 publications

A Thoracic Mass Discovered at Abdominal Imaging

A Thoracic Mass Discovered at Abdominal Imaging

Predictors of behaviour in solitary fibrous tumours of the pleura surgically resected: Analysis of 107 patients

Non-mesothelial Tumors of the Pleura

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