Primary malignant localized fibrous tumours of the pleura: clinical, radiological and pathological features.

Localized fibrous tumours of the pleura are rare primary pleural tumours that may exhibit malignant behaviour in approximately 20% of cases. The clinical, radiological and pathological features of five patients with malignant localized fibrous tumours of the pleura are presented. Clinical symptoms included chest pain, breathlessness and cough. Hypertrophic pulmonary osteoarthropathy (HPOA) occurred in one patient. Chest radiographs and thoracic computed tomography (CT) demonstrated large necrotic masses, with focal calcification and compressive atelectasis of the underlying lung. Histological features were variable and resulted in designation of these tumours as localized fibrous tumours of the pleura of low or high grade malignancy. The grading of malignancy did not correlate with final outcome, adequacy of surgical excision being the most important factor. These tumours have been referred to as benign pleural fibromas or localized mesotheliomas, but these names are inaccurate and the term localized fibrous tumour of the pleura is to be preferred. This term should also include tumours such as malignant fibrous histiocytoma of the pleura.