Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Solitary fibrous tumor of the pleura
- Radiologic Findings
- Chest radiograph demonstrates a well-marginated large mass in the left upper hemithorax. Contrast-enhanced chest CT scan demonstrates a homogenously enhancing soft-tissue mass in the left upper hemithorax with serpiginous branching linear areas of enhancement consistent with intralesional vessels.
- Brief Review
- Solitary fibrous tumor (SFT) is a rare neoplasm that typically presents as a well-defined lobulated soft tissue mass commonly arising from the visceral pleura. The tumors typically affect the pleura but can develop in a number of other locations including the mediastinum, lung, tracheobronchial tree, abdomen, head, neck, and central nervous system. It is common in the fifth and sixth decades of life but can develop at all ages and occur equally in males and females. Chest pain is the most common symptom, and enlarging tumors can compress bronchus, causing atelectasis.
Chest radiographs of a patient with SFT of the pleura characteristically demonstrate a peripheral, well-defined, solitary nodule or mass. CT images of small SFTs typically show homogeneous, well-defined, lobular, non-invasive, soft-tissue nodules or masses. SFTs usually enhance strongly after contrast injection, which can be heterogeneous, particularly for large tumors. Heterogeneous attenuation of the tumor after contrast enhancement is correlated with hemorrhage, necrosis, or cystic change. Tumoral calcification occurs in 7% to 25% of patients, typically in those with larger tumors, and is often related to necrosis.
Surgical resection is the best treatment option. More than half are pedunculated, and video-assisted thoracic surgery (VATS) is preferred to open surgery. Histologically, SFTs appear benign, although large tumors can show central necrosis and some atypia.
- References
- 1. Rosado-de-Christenson ML, Abbott GF, McAdams HP, Franks TJ, Galvin JR. From the archives of the AFIP: localized fibrous tumor of the pleura. Radiographics. 2003;23:759–783.
2. Solitary Fibrous Tumor of the Pleura, Lary A. Robinson, MD, cancer control, October 2006, Vol. 13, No. 4
- Keywords
- pleura, Benign tumor,