Giant solitary fibrous tumor of the pleura

Abstract

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

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