Mezzetti Maurizio, Panigalli Tiziana, Giudice Fabio Lo, Cappelli Roberto, Giuliani Luigi, Raveglia Federico, Meda Stefano
Department of General and Thoracic Surgery, San Paolo Hospital, University School of Medicine of Milan, Via Boccaccio 27, 20123 Milan, Italy.
Crit Rev Oncol Hematol. 2003 Jul;47(1):29-33. doi: 10.1016/s1040-8428(02)00174-9.
The localized benign fibrous tumor of the pleura represents 8% of all benign pathologies of the chest and 10% of neoplasms of the pleura. The authors review the literature, and report on 15 cases of localized benign fibrous tumors of the pleura surgically treated over a period of 15 years to further knowledge of this pathology, its therapy and prognosis.
With respect to the well-known diffuse malignant mesothelioma, different etiopathogenesis, prognosis, and therapeutic approaches characterize the localized benign fibrous tumor of the pleura. In our experience, 15 patients underwent thoracotomy with excision of a pathological endothoracic mass, then histologically proved to be a localized benign tumor of the pleura. The whole group underwent pre-operative evaluation and, when clinic suggested, stadiation and post-operative frequent follow-up.
The whole group of 15 patients underwent surgical approach well tolerated the surgical treatment with perfect recovery of post-operative respiratory function. There was no relapse of disease in any patients. At the moment all patients are still alive except one dead of heart failure.
The differential diagnosis of benign fibrous tumor of the pleura and lung and pleural malignancy depends upon immunohistochemistry of the surgical specimen so that prognosis could be formulated only after surgery. We consider surgery as the treatment of choice in this pathology.
局限性胸膜良性纤维瘤占胸部所有良性病变的8%，占胸膜肿瘤的10%。作者回顾文献，并报告15年间手术治疗的15例局限性胸膜良性纤维瘤病例，以进一步了解这种病理状况、其治疗方法及预后。
与广为人知的弥漫性恶性间皮瘤不同，局限性胸膜良性纤维瘤具有不同的病因、预后及治疗方法。根据我们的经验，15例患者接受了开胸手术，切除胸腔内病理性肿块，术后经组织学证实为局限性胸膜良性肿瘤。整个研究组均接受了术前评估，并在临床提示时进行分期及术后频繁随访。
整个15例患者的手术组对手术治疗耐受良好，术后呼吸功能完全恢复。所有患者均无疾病复发。目前，除1例死于心力衰竭外，所有患者均存活。
胸膜良性纤维瘤与肺及胸膜恶性肿瘤的鉴别诊断取决于手术标本的免疫组织化学检查，因此只有在手术后才能制定预后方案。我们认为手术是这种病理状况的首选治疗方法。
