Giant solitary fibrous tumor of the pleura

TL;DR

This study describes the clinical features, diagnostic procedures, surgical management, and outcomes of six patients with giant solitary fibrous tumors of the pleura, emphasizing the importance of accurate diagnosis and preoperative embolization.

Contribution

It provides detailed clinical and surgical data on giant solitary fibrous tumors of the pleura, highlighting diagnostic and management strategies for this rare condition.

Findings

Most patients were symptomatic with dyspnea, cough, and chest pain.

Preoperative embolization facilitated successful surgical resection.

Long-term follow-up is necessary due to potential recurrence.

Abstract

Background: Solitary fibrous tumor is the second primary malignancy of the pleura and can reach up to 39cm in diameter; to be referred to as giant it must occupy at least 40% of the affected hemithorax. Although this tumor usually shows a benign behavior malignancy criteria have been described. The aim of the study was to assess the initial evaluation diagnostic procedures surgical management treatment outcome and prognosis. Methods: We performed a descriptive observational longitudinal and retrospective study from 2002 to 2006 on patients who underwent surgery with a diagnosis of giant solitary fibrous tumor of the pleura. Results: Six patients were included; 83.3% were females. Mean age was 48 years. All patients were symptomatic mainly dyspnea cough and chest pain; 66.7% were left-sided. Preoperative angiography and embolization were performed in 83.3% cases with successful surgical resection. The predominant blood supply was derived from the internal mammalian artery. Intraoperative complication rate was 17%. A vascular pedicle was found in 66.7%. The largest lesion was 40cm in diameter and weighed 4500g. Only one case showed high mitotic activity. Mean follow-up to date is 14 months. Conclusions: Symptomatology found was consistent with previous reports but in higher percentages. Accurate diagnosis is critical because surgical resection involves a potential cure; long-term follow-up is mandatory. Preoperative embolization is recommended due to tumor size.