Barata Margarida, Cabral Daniel, Sequeira Pedro, Couto Carlos, Oliveira Ana, Rodrigues Cristina
Department of Pulmonology, Hospital Garcia de Orta, Almada, Portugal.
Department of Thoracic Surgery, Hospital Pulido Valente, Centro Hospital Universitário Lisboa Norte, Portugal.
Respir Med Case Rep. 2021 Apr 18;33:101411. doi: 10.1016/j.rmcr.2021.101411. eCollection 2021.
Solitary fibrous tumor of the pleura (SFTP) is a rare tumor. The prognosis is relatively good, but up to 20% of the cases are malignant. We presented a case of a large mass of the thorax, showing malignant poor prognosis features. A 73-year-old male, former smoker, presented with a history of dry cough. Chest CT revealed a left bronchopulmonary mass (11 cm × 14 cm) extending from the costal pleura to the left hilum. Histopathologic examination of the transbronchial lung biopsy was consistent with SFTP. A left pneumonectomy was performed due to invasive nature of the lesion. According to features associated to poor prognosis (lung tumor ≥ 10 cm, hipercellularity, abundant intratumor blood vessels and areas of necrosis), and in spite of proliferation index (Ki67+) <1%, the case was discussed in a multidisciplinary meeting, and was assumed to be malignant. At the present time, the patient is his fifth month after surgery, in tight follow up. This case highlights a rare SFTP presenting bad prognosis features, that although completely resected should have long-term follow-up due to the high risk of recurrence.
胸膜孤立性纤维瘤（SFTP）是一种罕见肿瘤。其预后相对较好，但高达20%的病例为恶性。我们报告了一例胸部巨大肿块病例，具有恶性预后不良特征。一名73岁男性，既往吸烟，有干咳病史。胸部CT显示左支气管肺肿块（11cm×14cm），从肋胸膜延伸至左肺门。经支气管肺活检的组织病理学检查结果与SFTP一致。由于病变具有侵袭性，遂行左肺切除术。根据与预后不良相关的特征（肺肿瘤≥10cm、细胞增多、肿瘤内血管丰富和坏死区域），尽管增殖指数（Ki67+）<1%，该病例在多学科会议上进行了讨论，并被认定为恶性。目前，患者术后已五个月，正在密切随访中。该病例凸显了一例具有不良预后特征的罕见SFTP，尽管已完全切除，但由于复发风险高，仍应进行长期随访。
