Giant Solitary Fibrous Tumor of the Pleura – Case Report


Authors: T. Toporcer 1;  J. Belák 2;  A. Böör 3;  M. Kudláč 2;  L. Lakyová 1;  J. Radoňak 1
Authors‘ workplace: I. chirurgická klinika, Lekárska fakulta, Univerzita Pavla Jozefa Šafárika, Košice, Slovenská republika prednosta: Prof. MUDr. J. Radoňak, CSc. 1;  II. chirurgická klinika, Lekárska fakulta, Univerzita Pavla Jozefa Šafárika, Košice, Slovenská republika prednosta: MUDr. J. Belák, Ph. D. 2;  Ústav patológie, Lekárska fakulta, Univerzita Pavla Jozefa Šafárika, Košice, Slovenská republika prednosta: Prof. MUDr. A. Böör, CSc. 3
Published in: Rozhl. Chir., 2009, roč. 88, č. 3, s. 97-102.
Category: Monothematic special - Original

Overview

Solitary fibrous tumors of the pleura are rare malignant pathological findings, accounting for only 5% of all pleural neoplasms. Clinical manifestations are very unspecific and over 50% of the cases are asymptomatic. The commonest clinical symptoms include cough, pains, dyspnoea, fever and weight loss. The recommended diagnostic methods include chest x-ray, CT and MRI imaging and positrone emission tomography. The CT-assissted puction biopsy yield is less than 50%.

The authors present a case review of a 58 year-old female with a history of dyspnoea. Her chest x-ray and CT examination suggested a large cystoid lesion in the right hemithorax, with extensive dystelectasis of the right lung lobe. Functional pulmonary examination confirmed severe gas transfer dysfunction, with diffusion lung capacity of 47% of the normal. Stenosis of the right middle and lower lobar bronchus resulting from extramusral pressure was detected on bronchoscopy. The authors performed right-sided thoracotomy and removed an encapsulated solid tumor measuring 24x16x13.5cm and weighting 2850grams from the thoracic cavity. Benign solitary fibrous tumor was diagnosed on histology. The postoperative course was complicated by bleeding into the pleural cavity, which was managed conservatively and did not require subsequent surgical revision. The patient was released for home care in a good condition. The aim of the study is to draw attention to this tumorous disorder of the pleura – the solitary fibrous tumor.

Key words:
benign solitary fibrous tumor – pleural tumor – thoracotomy


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