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Weekly Chest CasesArchive of Old Cases

Case No : 999 Date 2016-12-19

  • Courtesy of Yeseul Jo, Kyongmin Beck, Dae Hee han, Jung Im Jung, Myoeng Im Ahn / Seoul st. Mary's hospital
  • Age/Sex 62 / F
  • Chief ComplaintChest radiograph abnormality
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Solitary fibrous tumor of pleura
Radiologic Findings
Chest PA and lateral view show about 6cm sized, pleural-based, well-defined mass in L upper paratracheal region.
After PCNB of the mass, chest PA shows left pneumothorax, and the mass moved to lower portion rather than upper medial portion of left hemithorax.
On CT scan (not shown), the mass shows heterogeneously enhancing pleural-based mass in left upper hemithorax without internal necrosis or calcification.
Brief Review
A solitary fibrous tumor of the pleura (SFTP) is a mesenchymal neoplasm that originates from the visceral pleura of the chest wall. It can be benign or malignant. It is rare, accounting for less than 5% of all pleural neoplasms. It most commonly occurs in the fifth or sixth decade of life, and has no significant sex predilection. Although approximately half of SFTP patients are asymptomatic, cough, chest pain, and dyspnea may be presented, especially in patients with relatively large tumors.
These lesions are often pedunculated with a fibrovascular stalk. On chest radiographs, pleural SFT appear as peripheral, smooth, well-demarcated soft-tissue-density masses. Pedunculated SFT can present as mobile masses at serial examination. CT can better depict the pleural origin of the lesions than radiography. On CT scans, heterogeneous enhancement due to myxoid degeneration is not unusual. Calcifications and pleural effusions are uncommon findings in pleural SFT. Enhancement is usually strong, but can be heterogeneous.
References
1. Briselli M, Mark EJ, Dickersin GR. Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature. Cancer 1981; 47:2678–2689
2. Ferretti GR, Chiles C, Choplin RH, et al. Localized benign fibrous tumors of the pleura. Am J Roentgenol 1997; 169:683–686
3. Daniel T. Ginat, Aqiba Bokhari, Shweta Bhatt, and Vikram Dogra. Imaging Features of Solitary Fibrous Tumors American Journal of Roentgenology 2011 196:3, 487-495


Keywords
pleura, Benign tumor,

No. of Applicants : 83

▶ Correct Answer : 48/83,  57.8%
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Union hospital,Wuhan , China Nan Diao
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - HIA Legouest - METZ , France Alban Gervaise
  • - King Abdulaziz University Hospital , Saudi Arabia Amr Ajlan
  • - McGill University Health Center , Canada Alexandre Semionov
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - Korea University Guro Hospital , Korea (South) Bit Na Park
  • - Ajou university hospital , Korea (South) Pae Sun Suh
  • - Korea University Guro Hospital , Korea (South) PARK SOYEON
  • - The University of Tokyo Hospital , Japan Yusuke Watanabe
  • - , Korea (South) SOOJUNG LEE
  • - Seoul National University Hospital , Korea (South) Ju Nam
  • - Asan Medical Center , Korea (South) Hyung Jung Koo
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - The Jikei university , Japan Taku Gomi
  • - The first affiliated Hospital of Xiamen University , China Qing Qiang Guo
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Ajou University Hospital , Korea (South) Taeyang Ha
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Asan medical center , Korea (South) Jihye Kwon
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Bahcesehir University School of Medicine, Radiology Department , Turkey Mustafa Kemal Demir
  • - Dong-A University Hospital , Korea (South) Ki-Nam Lee
  • - Medicheck health care , Korea (South) Chae hun Lim
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Han Na Lee
  • - MAGNUM DIAGNOSTICS - Goa INDIA , India Paresh K Desai
  • - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
  • - CLINIQUE STE CLOTILDE , Reunion patrick serge MASCAREL
  • - Okayama University Hospital , Japan Toshiyuki Komaki
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - University of Tsukuba, Dept of Radiology , Japan Manabu Minami
  • - Centre Hospitalier Regional de Lanaudiere , Canada Matthieu Storme
  • - Seoul national university hospital , Korea (South) Kumju Chae
  • - Konkuk University Medical Center , Korea (South) Yong Wonn Kwon
  • - Kanto Rosai Hospital , Japan Taku Tajima
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Korea university medical center, guro hospital , Korea (South) Lee chong
  • - Korea university medical center, guro hospital , Korea (South) JINWOO HAN
  • - Korea University Guro Hospital , Korea (South) Sun Hong
  • - Bundang CHA hospital , Korea (South) Dongjun Lee
  • - Korea University Guro Hospital , Korea (South) Jeong Woo Kim
  • - University of Utah , United States AKIHIKO SAKATA
  • - the first affiliatited hospital of nanjing medical univercity , China Hai Xu
  • - Korea University Guro Hospital , Korea (South) Hwanseok Yong
  • - Hanyang University Hospital , Korea (South) Yo Won Choi
▶ Correct Answer as Differential Diagnosis : 4/83,  4.8%
  • - Saitama-Sekishinkai Hosptal , Japan Mihoko Yamazaki
  • - Centro Hospitalar S. Joao , Portugal Marcio Cunha Rodrigues
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Private sector , Greece VASILIOS TZILAS
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