Solitary malignant fibrous tumor of the pleura

Tumor fibroso maligno solitario de pleura

Introduction: solitary fibrous tumors of the pleura are rare mesenchymal tumors, composed of spindle cells, arising from the superficial pleura lining and/or underlying connective tissue. They represent 5% of all pleural tumors and 20% of them are malignant. Diagnosis is based on chest radiograph, from which a pleural lesion is initially suspected, and must be accurately diagnosed after further diagnostic studies to provide optimal management and follow-up. Case presentation: a 70-years-old male patient consulting for a 3-month history of progressive chest pain, cough, and dyspnea, with no history of asbestos exposure. Chest x-ray showed a mass of apparent pleural origin. Chest contrast-enhanced CT scan demonstrated a solitary vascularized and calcified fibrous pleural mass. Biopsy revealed a malignant solitary fibrous tumor of the pleura. Immunohistochemistry was positive for STAT6, CD34, Vimentin and BCL2. Patient underwent surgical resection with an uneventful postoperative course and follow-up was performed every 3 months. Conclusion: solitary fibrous tumors of the pleura are infrequent, thus other more common causes should be considered to reach an accurate diagnosis. Distinction between benign and malignant tumors and the size of the mass are essential for providing the right management and follow-up due to their unpredictable behavior and postoperative progression.