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Weekly Chest CasesArchive of Old Cases

Case No : 1120 Date 2019-04-16

  • Courtesy of Sung Ho Hwang, Yu-Whan Oh / Korea University Anam Hospital
  • Age/Sex 50 / F
  • Chief Complaintpalpable mass in anterior chest wall
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Solitary fibrous tumor of pleura
Radiologic Findings
Chest radiography shows round mass-like opacity in right lower lung field (Fig. 1). Transverse image of pre-contrast CT (Fig. 2) shows a well-defined nodule (2 cm in size) involving both pleura and intercostal space of right hemithorax. Post-contrast CT image (Fig. 3) shows heterogeneous and strong contrast enhancement in the right chest wall nodule. Furthermore, the chest wall nodule also shows hypermetabolism on FDG-PET image (Fig. 4).
Brief Review
Fibrous tumors most commonly occur in the pleura but have also been described in the pericardium, mediastinum, lung, peritoneum, chest wall, orbits, and other sites. About 12% of solitary fibrous tumors are malignant and eventually lead to death through local recurrence or metastatic disease. The tumors are usually well circumscribed. They range in size from 1 to 36 cm, with a mean of 6 cm. Approximately 50% have a pedicle attached to the pleura, 1 cm in length, that contains hypertrophic arteries and veins. As tumors enlarge, they appear more heterogeneous; areas of necrosis, hemorrhage, and cystic changes are typically identified within the lesions. benign solitary fibrous tumors demonstrated low-grade FDG uptake, and malignant solitary fibrous tumors demonstrated somewhat greater FDG uptake based on standardized uptake values. Complete surgical resection is the treatment of choice.
Please refer to
Case 43, Case 80, Case 121, Case 353, Case 405, Case 530, Case 672, Case 694, Case 836, Case 875, Case 940, Case 975, Case 981, Case 999,
KSTR imaging conference 2018 Summer  Case 2 ,
KSTR Imaging conference 2010 Summer  Case 16 ,
KSTR Imaging Conference 2008 Summer  Case 1,
References
1. M de Perrot, S Fischer, MA Brundler, et al.: Solitary fibrous tumors of the pleura. Ann Thorac Surg. 2002;74:285-293
2. YK Yeom, MY Kim, HJ Lee, SS Kim: Solitary fibrous tumors of the pleura of the thorax: CT and FDG PET characteristics in a tertiary referral center. Medicine (Baltimore). 2015;94 (38):e1548
Keywords
pleura, solitary fibrous tumor of pleura,

No. of Applicants : 82

▶ Correct Answer : 10/82,  12.2%
  • - Mayo Clinic , United States AKITOSHI INOUE
  • - Other , Korea (South) CHUNGEUN LIM
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Dae Jin Medical Center , Korea (South) JIYOUNG CHOI
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
  • - Resident , India FAISAL SYED
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
▶ Correct Answer as Differential Diagnosis : 20/82,  24.4%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - TWMU Medical Center East , Japan MASAFUMI KAIUME
  • - King Abdulaziz University Hospital , Saudi Arabia Amr M. Ajlan
  • - Chonbuk National University Hospital , Korea (South) EUN HA JUNG
  • - Other , Korea (South) SEONGSU KANG
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Kurashiki Central Hospital , Japan HISATAKA ITO
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Gifu University Hospital , Japan Yo Kaneko
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Azienda Ospedaliera di Cremona , Italy Pietro Sergio
  • - Chungbuk National University Hospital , Korea (South) HYE SOO CHO
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Kyoto Prefectural University of Medicine , Japan TADASHI TANAKA
  • - National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
▶ Semi-Correct Answer : 13/82,  15.9%
  • - Niigata University , Japan ATSUSHI UEHARA
  • - Ajou University School of Medicine , Korea (South) JUNG YONG JUN
  • - Cabinet Capricorne, clinique sainte-clotilde , Reunion FABIEN HO
  • - Chonbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - Ajou University Hospital , Korea (South) DAYOUNG KIM
  • - , Japan NAOMI YUASA
  • - Asan Medical Center , Korea (South) JIHOON KIM
  • - TB centre kasaragod. , India rikhy krishnan
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Ajou University Hospital , Korea (South) YOO YOUNGJIN
  • - Jiangsu province hospital , China WANGJIAN ZHA
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Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

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