Department of Pneumology, Sint-Elisabeth Hospital, Zottegem, Belgium
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
BMJ Case Rep. 2024 Mar 19;17(3):e257161. doi: 10.1136/bcr-2023-257161.
A woman in her 30s, non-smoker, presented at the emergency department two times because of spontaneous pneumothorax. The first episode was treated with small bore catheter drainage, while during the second episode-occurring only 1 week later-thoracoscopic talcage was attempted. The postoperative course was characterised by slow clinical and radiological resolution, and recurrence 3 days after discharge. Eventually, multiportal video-assisted thoracoscopic exploration identified an interfissural solid mass. Resection and further work-up revealed the diagnosis of 'low-risk' solitary fibrous tumour (SFT) stage pT1N0M0. The interdisciplinary tumour board advised no adjuvant therapy. A CT thorax was scheduled in 1 year for follow-up. The patient was discharged without complications and has had no recurrences of pneumothorax at 6 months of follow-up. This report shows that SFT can easily be missed on initial presentation and should be considered in the differential diagnosis of pneumothorax, especially when frequently recurring.
一位 30 多岁的女性，不吸烟，因自发性气胸两次到急诊科就诊。第一次发作采用小口径导管引流治疗，而第二次发作（仅在 1 周后）则尝试了胸腔镜滑石粉固定术。术后病程表现为临床和影像学缓慢缓解，出院后 3 天复发。最终，多端口电视辅助胸腔镜探查发现了一个界面间实性肿块。切除和进一步检查显示诊断为“低风险”孤立性纤维瘤（SFT）分期 pT1N0M0。多学科肿瘤委员会建议不进行辅助治疗。计划在 1 年内进行胸部 CT 随访。患者无并发症出院，在随访 6 个月时气胸无复发。本报告表明，SFT 在初次就诊时很容易被遗漏，在气胸的鉴别诊断中应考虑到 SFT，特别是在频繁复发时。
