Abe Masaru, Nomori Hiroaki, Fukazawa Motoji, Sugimura Hiroshi, Narita Makoto, Takeshi Akihiko
Department of Thoracic Surgery, Kameda Medical Center, Kamogawa, Chiba, Japan.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:441-4. doi: 10.5761/atcs.cr.13-00154. Epub 2013 Oct 3.
We present 3 cases of solitary fibrous tumors (SFTs) occupying entire hemithorax and resulting in respiratory insufficiency. All patients were treated by complete resection, resulting in immediate re-expansion of the lungs and recovery from respiratory insufficiency. Although, two patients remain alive without recurrence, one patient had pleural recurrences three times over a 20-year period, all of which were treated by surgical resection. All of the primary tumors exhibited areas of hypercellularity, hemorrhage, or necrosis. All of the recurrent tumors in the recurrent case displayed large areas of hypercellularity, similar to the part of primary tumor. Although, the MIB-1 index in primary tumors was less than 5%, the index of the recurrent tumors increased up to 11% with repeated recurrence. Giant SFTs usually display hypercellularity, hemorrhage, or necrosis. Tumors with hypercellularity could recur. MIB-1 index could display malignant characteristics of recurrent tumors. Long-term follow-up for more than 10 years after surgery is necessary, particularly for tumors with areas of hypercellularity.
我们报告3例孤立性纤维瘤（SFTs）占据整个半侧胸腔并导致呼吸功能不全的病例。所有患者均接受了完整切除，肺部立即复张，呼吸功能不全得以恢复。尽管有2例患者存活且无复发，但1例患者在20年期间胸膜复发3次，均通过手术切除进行治疗。所有原发性肿瘤均表现出细胞增多、出血或坏死区域。复发病例中的所有复发性肿瘤均显示出大面积的细胞增多，类似于原发性肿瘤的部分区域。尽管原发性肿瘤的MIB-1指数小于5%，但复发性肿瘤的指数随着反复复发增加至11%。巨大SFTs通常表现出细胞增多、出血或坏死。具有细胞增多的肿瘤可能会复发。MIB-1指数可显示复发性肿瘤的恶性特征。术后需要进行超过10年的长期随访，特别是对于具有细胞增多区域的肿瘤。
