Giant solitary fibrous tumor of the pleura

• Published in: Cirugia y cirujanos Vol. 78; no. 1; p. 31
• Main Authors: Pinedo-Onofre, Javier Alfonso, Robles-Pérez, Eurídice, Peña-Mirabal, Erika Sagrario, Hernández-Carrillo, José Amado, Téllez-Becerra, José Luis
• Format: Journal Article
• Language: English
• Published: Mexico 01.01.2010
• Subjects: Adult; Aged; Angiography; Combined Modality Therapy; Dyspnea - etiology; Embolization, Therapeutic; Female; Follow-Up Studies; Histiocytoma, Malignant Fibrous - epidemiology; Histiocytoma, Malignant Fibrous - pathology; Humans; Intraoperative Complications - epidemiology; Male; Middle Aged; Neoadjuvant Therapy; Pleural Neoplasms - blood supply; Pleural Neoplasms - diagnostic imaging; Pleural Neoplasms - epidemiology; Pleural Neoplasms - pathology; Pleural Neoplasms - surgery; Pleural Neoplasms - therapy; Retrospective Studies; Solitary Fibrous Tumors - blood supply; Solitary Fibrous Tumors - diagnostic imaging; Solitary Fibrous Tumors - epidemiology; Solitary Fibrous Tumors - pathology; Solitary Fibrous Tumors - surgery; Solitary Fibrous Tumors - therapy; Tomography, X-Ray Computed
• ISSN: 2444-054X

Solitary fibrous tumor is the second primary malignancy of the pleura and can reach up to 39 cm in diameter; however, 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. 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. 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 40 cm in diameter and weighed 4500 g. Only one case showed high mitotic activity. Mean follow-up to date is 14 months. Symptomatology found was consistent with previous reports but in higher percentages. Accurate diagnosis is critical because surgical resection involves a potential cure; however, long-term follow-up is mandatory. Preoperative embolization is recommended due to tumor size.