title: Malignant giant solitary fibrous tumor of the pleura metastatic to the thyroid gland.
abstract: OBJECTIVE
  Solitary fibrous tumor (SFT) of the pleura is a rare mesenchymal neoplasm arising from mesenchymal cells in the areolar tissue subjacent to the mesothelial-lined pleura and accounting for less than 5% of primary pleural tumors. SFTs are generally benign and asymptomatic, with 10-year survival rates of up to 98%. Unfortunately, approximately 10% have malignant potential, leading to local recurrence after radical surgery and/or metastatic spread. Of note, giant pleural SFT, which consists of a tumor occupying at least 40% of the affected hemithorax, is even less common with only anecdotal cases reported in the medical literature.
  
  
  METHODS
  We describe a unique case of giant SFT of the pleura that metastasized to the thyroid gland 1 year after complete resection, focusing on its clinical and pathological features of presentation.
  
  
  RESULTS
  En bloc resection remains the mainstay of therapy with curative intent. Patients with large tumors may undergo preoperative angiography with percutaneous embolization of the tumor, which allows to reduce perioperative bleeding. In case of local recurrence, surgery still remains the best treatment option. However, surgery can also be considered in patients with isolated metastatic spread.
  
  
  CONCLUSIONS
  Every suspected and proven SFT of the pleura should undergo surgical resection, as clinical and radiological criteria cannot accurately distinguish benign from malignant forms. Moreover, the peculiar histological features of SFT should not be neglected when planning clinicoradiological follow-up. Additionally, suspicious clinical findings during follow-up should always be thoroughly investigated in order to exclude or confirm the diagnosis of recurrent disease.
authors.affiliation: Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia - Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Ricciuti
authors.affiliation: Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia - Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Metro
authors.affiliation: Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia - Italy.
authors.forename: Giulia Costanza
authors.initials: GC
authors.lastname: Leonardi
authors.affiliation: Department of Experimental Medicine and Biochemical Sciences, Section of Anatomic Pathology and Histology, University of Perugia, Perugia - Italy.
authors.forename: Rachele Del
authors.initials: RD
authors.lastname: Sordo
authors.affiliation: Department of Experimental Medicine and Biochemical Sciences, Section of Anatomic Pathology and Histology, University of Perugia, Perugia - Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Colella
authors.affiliation: Department of Thoracic Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia - Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Puma
authors.affiliation: Department of Thoracic Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia - Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ceccarelli
authors.affiliation: Department of Thoracic Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia - Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Potenza
authors.affiliation: Department of Diagnostic Imaging, Santa Maria della Misericordia Hospital, University of Perugia, Perugia - Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rebonato
authors.affiliation: Department of Diagnostic Imaging, Santa Maria della Misericordia Hospital, University of Perugia, Perugia - Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Maiettini
authors.affiliation: Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia - Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Crinò
authors.affiliation: Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia - Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Chiari
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D007150:Immunohistochemistry; D049268:Positron-Emission Tomography; D011859:Radiography; D054363:Solitary Fibrous Tumor, Pleural / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D013908:Thoracotomy; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome