A right pleural mass was detected incidentally in a 52-year-old woman and chest computed tomography showed lobulated pleural mass. Thoracoscopic excision was performed. Histology showed solitary fibrous tumor with extensive cystic change. Solitary fibrous tumor with extensive cystic change is very rare and we treated this tumor successfully with video-assisted thoracic surgery.
Solitary fibrous tumors of the pleura (SFTPs) are rare and SFTPs are different clinical behavior from malignant pleural tumors such as mesothelioma. Most of SFTPs are benign but some tumors grow aggressively. SFTPs grow large but extensive cystic change rarely. Sometimes large cystic SFTPs are misdiagnosed as pneumothorax. We experience a case involving a 52-year-old woman who was misdiagnosed as pneumothorax and underwent video assisted thoracic resection of SFTPs with extensive cyctic change and introduce.
A right pleural mass was detected incidentally in a 52-year-old woman during an annual medical checkup. This had not been detected two years earlier. She had no specific symptoms, or medical history. On physical examination, slightly decreased breath sounds were noted in the right lung field. A chest X-ray showed focal opacification in the right lower thorax, suggestive of an extrapleural mass. Contrast-enhanced chest computed tomography (CT) showed a lobulated pleural mass arising from the parietal pleura, with a lobulated elongated contour and mild contrast enhancement, suggesting a localized fibrous tumor of the pleura. A localized pneumothorax was noted (
Pleural tumors show various patterns and can be diffuse, e.g., a pleural mesothelioma, or localized, e.g., a fibrous tumor. This rare tumor has been given many names because of its origin and character and was thought to be a benign, localized form of malignant pleural mesothelioma. However, improvements in diagnostic techniques such as immunohistochemical methods and electron microscopy have defined this tumor as SFTPs, revealing its distinct status and histological character from malignant mesothelioma [
Solitary fibrous pleural tumors are more common in the fifth and sixth decades of life, but can develop at all ages. There occur equally in males and females. Over 75% of patients with malignant mesotheliomas have respiratory or other symptoms, while only about 50% of SFTP patients have symptoms. Chest pain is the most common symptom and enlarging tumors can compress the bronchus causing atelectasis. Paraneoplastic syndrome can appear if the tumor is large [
High resolution computed tomography showed pleural mass and localizing pneumothorax.
Mass with cystic change was seen and resected.