CT signs of solitary fibrous tumors of the pleura
Department of Surgery, University of Kentucky
J Thorac Dis 2010;2:4-5. DOI: 10.3978/j.issn.2072-1439.2010.02.01.e12
Editorial
CT signs of solitary fibrous tumors of the pleura
Department of Surgery, University of Kentucky
J Thorac Dis 2010;2:4-5. DOI: 10.3978/j.issn.2072-1439.2010.02.01.e12
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Solitary fibrous tumor of the pleura is a rare clinical entity. It was first described by Klemperer
and Rabin in 1931 (1). It is a mesenchymal tumor arising from the pleura of the thoracic cavity;
however, it has been reported from extrathoracic sites also (2). It may be broad based or pedunculated.
I have had personal experience with seven such cases and they were all pedunculated and varied
in size from 1 x 1.5 cm to 9.5 x 9.5 x 5 cm. SFTP is a well delineated, often lobulated soft tissue
mass in close relationship to a pleural surface (9). The final diagnosis is established by histological
examination of the tissue. The authors of this paper have presented a series of ten cases with various
radiographic findings with a special emphasis on CT scan (10). CT findings are highly suggestive but
not diagnostic. CT scan cannot be a substitute for a tissue diagnosis. CT findings are dependent on
the size of the tumor. When the tumor is small, it develops an obtuse angle with the pleural surface.
This angle changes to an acute angle when the tumor becomes large. Dedrick et al, described CT
finding of "Smoothly tapering margin" as highly characteristic of this tumor (4). The tumor mass inside
the fissure could be confused with a parenchymal mass. Finding of intralesional calcification is
often seen in large lesions (3). The primary author of this paper has reported on several occasions
about his experience of this tumor in multiple other journals (5,6,7). He continues to add information
to make our readers aware of this unique tumor and CT findings. The location of this tumor in the
paraspinal area could be confused with a neurogenic tumor. This is an interesting paper that describes
several unique CT findings that could make the reader aware of this rare tumor in multiple different
locations of the chest. I agree with the conclusion made by the authors (8), "The Chest Computed Tomography
(CT) Scan is the key examination, which shows the size and location of the tumor and aids
in surgical planning." There is no substitute for a tissue diagnosis. In my opinion, FNA or a CT guided
needle biopsy is an unnecessary procedure in the management of this disease in most cases. Surgical
resection offered the best chance for long-term cure and establishes the final pathologic diagnosis
of this rare tumor.
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References
Cite this article as: Saha SP. CT signs of solitary fibrous tumors of the pleura. J Thorac Dis 2010;2:4-5. doi: 10.3978/j.issn.2072-1439.2010.02.01.e12
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