de Perrot M, Kurt A M, Robert J H, Borisch B, Spiliopoulos A
Department of Surgery, University Hospital of Geneva, Switzerland.
Ann Thorac Surg. 1999 May;67(5):1456-9. doi: 10.1016/s0003-4975(99)00260-x.
Solitary fibrous tumors of the pleura are rare and present unpredictable clinical behavior.
Between 1981 and 1998, 11 solitary fibrous tumors of the pleura were resected in 10 patients at the University Hospital of Geneva. Their clinical behavior and outcome were reviewed.
Seven tumors arose from the visceral pleura, and three arose from the parietal pleura. Tumors arising from the parietal pleura were revealed to be more difficult to resect than those from the visceral pleura because of their size and adhesion to the chest wall requiring extrapleural resection. Eight tumors showed benign features, whereas two showed distinct features of malignity. One additional patient presented marked pleomorphism that could represent an intermediate form before frank malignity. Four tumors had been followed expectantly for 2 to 10 years before surgery. Although three enlarged rapidly, no signs of malignity were observed on histological examination. All patients are alive, from 2 months to 14 years after surgery (mean 55 months). In one case, however, a malignant tumor recurred 6 years after resection of a benign variant.
Although histologically benign, solitary fibrous tumors of the pleura may enlarge rapidly and occasionally transform into malignant variants after several years. Therefore, complete surgical resection and long-term follow-up is recommended for all patients.
胸膜孤立性纤维瘤罕见，临床行为难以预测。
1981年至1998年间，日内瓦大学医院对10例患者的11个胸膜孤立性纤维瘤进行了切除。回顾了其临床行为和转归。
7个肿瘤起源于脏层胸膜，3个起源于壁层胸膜。起源于壁层胸膜的肿瘤因其大小以及与胸壁的粘连而需要胸膜外切除，故比起源于脏层胸膜的肿瘤更难切除。8个肿瘤表现为良性特征，2个表现出明显的恶性特征。另有1例患者表现出明显的多形性，可能代表着在出现明显恶性之前的一种中间形式。4个肿瘤在手术前已进行了2至10年的观察。尽管其中3个迅速增大，但组织学检查未发现恶性迹象。所有患者均存活，术后2个月至14年（平均55个月）。然而，有1例患者在切除良性病变6年后出现了恶性肿瘤复发。
尽管胸膜孤立性纤维瘤在组织学上为良性，但可能迅速增大，且数年后偶尔会转变为恶性病变。因此，建议对所有患者进行完整的手术切除并长期随访。
