Solitary malignant fibrous tumor of the pleura Tumor fibroso solitario de pleura

Abstract

Introduction: Solitary fibrous tumors of the pleura are rare spindle cell tumors of mesenchymal origin that grow from the superficial pleural lining and / or the underlying connective tissue, it represents 5% of all pleural tumors and their malignant distinction is only 20 % of the cases. Its diagnosis is based initially on a chest X-ray from which a pleural lesion begins to be suspected, which after several complementary studies must be correctly differentiated for optimal management and follow-up.

Clinical case: A 70-year-old male with a 3-month history of progressive chest pain, cough and dyspnea with no exposure to asbestos, in whom a chest x-ray was initially taken showing a mass of apparent pleural origin, later with a contrast-enhanced chest tomography in which a calcified and vascularized solitary fibrous pleural mass was correctly differentiated. The final result of the biopsy was a malignant solitary fibrous pleural tumor with positive immunohistochemistry for STAT6, CD34, VIMENTIN and BCL2 markers, for which he underwent surgical resection with a correct postoperative evolution and follow-up every 3 months. Conclusion: Solitary fibrous tumors of the pleura are still uncommon, which is why other more common causes must first be considered in order to reach an accurate diagnosis. The distinction between benignity and malignancy, in addition to its size, is very important to achieve correct management and good follow-up due to its strange behavior and postoperative evolution.