Giant solitary fibrous tumor of the pleura.
BACKGROUND
Solitary fibrous tumor is the second primary malignancy of the pleura and can reach up to 39 cm in diameter; however, to be referred to as 'giant' it must occupy at least 40% of the affected hemithorax. Although this tumor usually shows a benign behavior, malignancy criteria have been described. The aim of the study was to assess the initial evaluation, diagnostic procedures, surgical management, treatment outcome, and prognosis.


METHODS
We performed a descriptive, observational, longitudinal, and retrospective study from 2002 to 2006 on patients who underwent surgery with a diagnosis of giant solitary fibrous tumor of the pleura.


RESULTS
Six patients were included; 83.3% were females. Mean age was 48 years. All patients were symptomatic, mainly dyspnea, cough and chest pain; 66.7% were left-sided. Preoperative angiography and embolization were performed in 83.3% cases with successful surgical resection. The predominant blood supply was derived from the internal mammalian artery. Intraoperative complication rate was 17%. A vascular pedicle was found in 66.7%. The largest lesion was 40 cm in diameter and weighed 4500 g. Only one case showed high mitotic activity. Mean follow-up to date is 14 months.


CONCLUSIONS
Symptomatology found was consistent with previous reports but in higher percentages. Accurate diagnosis is critical because surgical resection involves a potential cure; however, long-term follow-up is mandatory. Preoperative embolization is recommended due to tumor size.
Pinedo-Onofre
Javier Alfonso
JA
Subdirección de Cirugía, Servicio de Anatomía Patológica, Instituto Nacional de Enfermedades Respiratorias, México, D.F., Mexico. dr_creatura@hotmail.com
Robles-Pérez
Eurídice
E
Peña-Mirabal
Erika Sagrario
ES
Hernández-Carrillo
José Amado
JA
Téllez-Becerra
José Luis
JL
D000328:Adult; D000368:Aged; D000792:Angiography; D003131:Combined Modality Therapy; D004417:Dyspnea / Q000209:etiology; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D051677:Histiocytoma, Malignant Fibrous / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010997:Pleural Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D054364:Solitary Fibrous Tumors / Q000098:blood supply / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D014057:Tomography, X-Ray Computed