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Weekly Chest CasesArchive of Old Cases

Case No : 775 Date 2012-09-05

  • Courtesy of Jung Im Kim, Hyun Ju Lee / Seoul National University Hospital
  • Age/Sex 31 / M
  • Chief ComplaintAbnormality on routine check up.
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6

Figure 1.

Diagnosis With Brief Discussion

Diagnosis
Solitary fibrous tumor
Radiologic Findings
Chest CT shows subpleural lobulated mass abutting the LUL lingular segment. The mass shows heterogenous enhancement on postcontrast image and it has sharply delineated border. A pedicle of the mass connects the mass and fissural pleura. After CBCT(cone-beam CT)-guided PCNA, the prone CT image demonstrate a change in mass position within the thorax that confirms its pleural location.
Brief Review
The solitary fibrous tumor (SFT) has been described as occurring mostly in the pleura, but it has also been reported in other thoracic areas (pericardium, mediastinum), the abdomen (peritoneum, retroperitoneum, liver), and exceptionally in the nasal cavity, sinuses, nasopharynx, parapharyngeal spaces, epiglottis, thyroid, parotid, and orbit. The solitary fibrous tumor of pleura (SFTP) develops between the fifth and seventh decades of life, regardless of a previous history of smoking or asbestos exposure, and usually it is of a benign nature, with the malignant form occurring in 12% of cases. The CT scan is an important step in the preoperative work-up because it can determine the relationship of the tumor to neighboring structures and assess its resectability. CT usually reveals a sharply delineated and sometimes lobulated mass, with the same density as the musculature, which is homogeneous in most cases, especially when the lesion is small. Larger neoplasms may have a heterogeneous appearance. Contrast-enhancement is usually intense and homogeneous, as a result of the rich vascularization. However, CT also may show non-enhanced areas that are due tonecrosis, myxoid degeneration, or hemorrhage within the tumor. The angles between the tumor and the chest wall can be acute and suggest a parenchymal mass. When the tumor is close to the mediastinum or diaphragm, its relationship to the surrounding structures is sometimes difficult to assess, even using.
References
1. Bini A, Brandolini J, Davoli F, Dolci G, Sellitri F, Stella F. Solitary fibrous tumor of the pleura: surgery and clinical course in 18 cases. Asian Cardiovasc Thorac Ann 2009; 17:378-381.
2. De Luca G, Griffo S, Cecere C, et al. Solitary fibrous tumor of the pleura mimicking neurogenic tumor. J Thorac Cardiovasc Surg 2006; 132:1241-1242.
3. 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.
Keywords
pleura, benign tumor,

No. of Applicants : 80

▶ Correct Answer : 52/80,  65.0%
  • - Hanam sungshim hospital , Korea (South) CHANG IL KIM
  • - Kurashiki Seijin-byo Center , Japan Akihiro Tada
  • - Kyung Hee Universitiy Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - Chuncheon Sacred Heart Hospital , Korea (South) Kyung bum Nam
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - UWO , Canada S Lee
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Radnet Teleradiology , Turkey Murat Ulusoy
  • - Asan medical center , Korea (South) Sang Young Oh
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - SCGH , Australia Yuranga Weerakkody
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - McGill University Health Center , Canada Alexandre Semionov
  • - CNUH , Korea (South) Kim soon yuan
  • - Fukuyama city hospital , Japan Ryotaro Kishi
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Babaeski Devlet Hastanesi , Turkey Umut Ugur
  • - H�pital du Sacr , Canada Andrea Ojanguren
  • - University of British Columbia , Canada Amr Ajlan
  • - CHRU lille , France manuel toledano
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Kyungpook National University Hospital , Korea (South) Jaekwang Lim
  • - Teikyo mizonokuchi hospital , Japan Takana Yamakawa
  • - SNUH , Korea (South) Euijin Hwang
  • - Dong-A University Hospital , Korea (South) Ji-yeon Han
  • - ASAN MEDICAL CENTER , Korea (South) CHONG HYUN SUH
  • - Asan Medical Center , Korea (South) Hye Jeon Hwang
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Asan Medical Center , Korea (South) Ji Eun Kim
  • - Ishikawa Matto Central Hospital , Japan Manabu Akimoto
  • - Asan Medical Center , Korea (South) Eunyoung Kim
  • - Chonnam national univ. hospital , Korea (South) Choi Seul-Gi
  • - Ilsan-paik hospital , Korea (South) Sungho LEE
  • - Hanyang University Hospital , Korea (South) Yo Won Choi
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Hanyang University Hospital , Korea (South) Jina Park
  • - chungbuk national university hospital , Korea (South) soojung lee
  • - Chungbuk National University Hospital , Korea (South) Su Jeong Hyun
  • - Chungbuk University Hospital , Korea (South) Yunhee Jang
  • - China Medical University , Chia-Yi Christian Hospital ,Taiwan, R.O.C. , Taiwan Jun Jun Yeh
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - CAC Rennes , France nicolas gautier
  • - All India Institute of medical sciences , India Justin Moses
  • - Chonnam National University Hospital , Korea (South) Jung hyun Kim
  • - HIA Legouest - METZ , France Alban Gervaise
  • - Radnet Teleradiology Istanbul , Turkey Armagan Sarac
  • - NDMVP Nashik , India Imran Jindani
  • - Chonnam National Univ. Hospital , Korea (South) Jaemyeong Jo
  • - chp st martin , France Mariotte benoit
▶ Correct Answer as Differential Diagnosis : 13/80,  16.3%
  • - Fleury , Brazil Gustavo Meirelles
  • - Toyama University Hospital, Laboratory of Pathology , Japan TOMONORI TANAKA
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - Goa Medical College , India Paresh Desai
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - Kohka Public Hospital , Japan Akitoshi Inoue
  • - Saint Malo , France jean-baptiste Noel
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - IRSA , France, Metropolitan BIGOT
  • - UZ GASTHUISBERG , Belgium Johan COOLEN
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Okayama university , Japan Mayu Uka
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