Department of Thoracic Surgery, "Marius Nasta" Institute of Pneumonology, 050152 Bucharest, Romania.
Department of Thoracic Surgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Medicina (Kaunas). 2020 Apr 16;56(4):185. doi: 10.3390/medicina56040185.
The purpose of this paper is to study the type, the clinical presentation, and the best diagnostic methods for pleural solitary fibrous tumors (PSFTs), as well as to evaluate which is the most appropriate treatment, especially as PSFTs represent a rare occurrence in the thoracic pathology. A retrospective study was conducted on a group of 45 patients submitted to surgery between January 2015 and December 2019. In most cases, the diagnosis was established through imaging studies-thoracic computed tomography (CT) scan with or without contrast-but also using magnetic resonance imaging (MRI) or positron emission tomography (PET) scans when data from CT scans were scarce. All patients were submitted to surgery with curative intent. : Most patients included in this study were asymptomatic, with this pathology being more common in patients over 60 years of age, and more common in women. The occurrence of malignant PSFT in our study was 17.77% (8 cases). All cases were submitted to surgery with curative intent, with a single case developing further recurrence. In order to achieve complete resection en bloc resection of the tumor with the chest wall, resection was performed in two cases, while lower lobectomy, pneumectomy, and hemidiaphragm resection, respectively, were needed in each case. Postoperative mortality was null. : Thoracic CT scan remains the most important imagistic investigation in diagnosing. MRI is superior to thoracic CT, especially in cases that involved the larger blood vessels within the thorax, spinal column, or diaphragm. Complete surgical resection is the gold standard in treatment of PSFT, and the prognosis in benign cases is very good.
本文旨在研究胸膜孤立性纤维瘤(PSFT)的类型、临床表现和最佳诊断方法,并评估哪种治疗方法最合适,尤其是因为 PSFT 在胸部病理学中较为罕见。
对 2015 年 1 月至 2019 年 12 月期间接受手术的 45 例患者进行了回顾性研究。在大多数情况下,通过影像学研究——胸部计算机断层扫描(CT)加或不加对比,但也使用磁共振成像(MRI)或正电子发射断层扫描(PET)扫描——来建立诊断,当 CT 扫描数据不足时。所有患者均接受治愈性手术。
大多数纳入本研究的患者无症状,该病理学在 60 岁以上患者中更为常见,在女性中更为常见。在我们的研究中,恶性 PSFT 的发生率为 17.77%(8 例)。所有病例均以治愈为目的进行手术,仅 1 例进一步复发。为了实现肿瘤整块切除,与胸壁一起切除,在两例中进行了手术,而在每例中分别需要进行下肺叶切除术、全肺切除术和半膈肌切除术。术后无死亡。
胸部 CT 扫描仍然是诊断的最重要影像学检查。MRI 优于胸部 CT,尤其是在涉及胸内、脊柱或膈肌较大血管的情况下。完全手术切除是 PSFT 治疗的金标准,良性病例的预后非常好。