Abstract

Introduction: This paper reports on an elderly African female who presented with a right intrathoracic space-occupying lesion, which was subsequently discovered to be a giant benign solitary fibrous tumor of the pleura—with a discussion of the surgical intervention that followed.

Case Report: Presented is the case of a 75-year-old female, who was referred to the Cardiovascular and Thoracic Surgery Unit, Federal Medical Center, Umuahia, Nigeria, with complaints of vague chest discomfort and progressive shortness of breath over 18 months. The imaging investigations were reviewed, indicating the need for a right posterolateral thoracotomy for tumor resection. The surgical procedure lasted approximately 2 hours, followed by an uneventful postoperative recovery. After one week, the patient was discharged, is currently asymptomatic, and is being seen on an outpatient basis.

Discussion: Pleural SFTs are rare neoplasms, most benign. Pleural SFTs present with various and distinct symptoms. Chest CT scanning is the preferred imaging technique. Nevertheless, the radiological differentiation between the benign and malignant variants remains challenging. Surgery is the treatment of choice for a solitary fibrous tumor of the pleura (SFTP). Local recurrence can present in malignant cases but is infrequent in solitary benign tumors. Surgical resection's prognosis is generally favorable, even for a malignant SFTP.

Conclusion: Rapid preoperative diagnosis followed by expeditious surgical intervention is the goal in the surgical resection of a solitary fibrous tumor (SFT), resulting in rapid symptomatic relief and long-term survival in benign and most malignant SFTs. SFTs are rare tumors, challenging to diagnose definitively.

Keywords: Atelectasis; Chest Imaging; Immunohistochemical; Index Patient; Posterolateral Thoracotomy; Respiratory System Surgery

References

1. Vejvodova S., et al. “Solitary Fibrous Tumor - Less Common Neoplasms of the Pleural Cavity”. Annals of Thoracic and Cardiovascular Surgery1 (2017): 12-18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347482/
2. Lu C., et al. “Solitary Fibrous Tumor of the Pleura: An Analysis of 13 Cases”. World Journal of Surgery8 (2008): 1663-1668. https://pubmed.ncbi.nlm.nih.gov/18427887/
3. Lococo F., et al. “Malignant Solitary Fibrous Tumors of the Pleura: Retrospective Review of a Multicenter Series”. Journal of Thoracic Oncology11 (2012): 1698-1706. https://pubmed.ncbi.nlm.nih.gov/23070244/
4. Perrotta F., et al. “Integrated therapeutic approach to giant solitary fibrous tumor of the pleura: report of a case and review of the literature”. Open Medicine1 (2016): 220-225. https://pubmed.ncbi.nlm.nih.gov/28352798/
5. Harrison-Phipps KM., et al. “Solitary fibrous tumors of the pleura: Results of surgical treatment and long-term prognosis”. The Journal of Thoracic and Cardiovascular Surgery1 (2009): 19-25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2930758/
6. Sung SH., et al. “Solitary Fibrous Tumors of the Pleura: Surgical Outcome and Clinical Course”. The Annals of Thoracic Surgery1 (2005): 303-307. https://pubmed.ncbi.nlm.nih.gov/15620963/
7. Cardillo G., et al. “Solitary Fibrous Tumors of the Pleura: An Analysis of 110 Patients Treated in a Single Institution”. The Annals of Thoracic Surgery5 (2009): 1632-1637. https://pubmed.ncbi.nlm.nih.gov/19853123/
8. Cieślik-Wolski B., et al. “Solitary fibrous tumor of the pleura - analysis of 18 cases”. Kardiochirurgia i Torakochirurgia Polska = Polish Journal of Cardio-Thoracic Surgery3 (2015): 208-215. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631912/
9. Ferretti GR., et al. “Localized benign fibrous tumors of the pleura”. American Journal of Roentgenology3 (1997): 683-686. https://www.ajronline.org/doi/pdf/10.2214/ajr.169.3.9275877
10. Moccia F., et al. “Stim and Orai proteins in neuronal Ca(2+) signaling and excitability”. Frontiers in Cellular Neuroscience 9 (2015): 153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408853/
11. Supakul R., et al. “Solitary Fibrous Tumor of the Pleura: A Rare Cause of Pleural Mass”. American Journal of Case Reports 16 (2015): 854-857. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671454/
12. Abstracts of Papers Presented at the Joint Association of Surgeons of Nigeria and Nigeriansurgical Research Society Meeting, Umuahia, Nigeria, July 2018”. Nigerian Journal of Surgery1 (2019): 107-130. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452750/