Recurrent malignant Solitary Fibrous tumor of the pleura: Case Report

Abstract

Solitary fibrous tumors (SFTs) of the pleura are rare neoplasms originating from the mesenchymal tissue of the pleura. We present a case report of a 64-year-old female patient who presented with shortness of breath, dizziness, and palpitations. She also experienced fever, productive cough with hemoptysis, pleuritic chest pain, weight loss, anorexia, and night sweats. Imaging revealed a large hyper vascular lobulated solid mass occupying the right middle and lower lobes of the lung, causing atelectasis. (Image) A biopsy confirmed the diagnosis of solitary fibrous tumor, which was surgically excised. Histopathology revealed a malignant solitary fibrous tumor confined to the pleura. Adjuvant radiation therapy was given. She was kept on surveillance imaging including PET scan for duration of 4 years without any evidence of disease recurrence. She developed radiation pneumonitis, requiring steroid treatment. After 4 years of surveillance, she developed local large recurrence of the tumor in the right lower chest extending to the right upper abdomen. She had successful resection of the recurrent fibrous tumor of the pleura which was done by thoracic and General surgery.
This case highlights the clinical presentation, diagnostic and management challenges for recurrent malignant fibrous tumor of the pleura, emphasizing the importance of a multidisciplinary approach in the management of such rare tumors.