Extended intrathoracic chest wall tumor: A case report.

Abstract

Introduction and importance: Solitary Fibrous Tumors (SFTs) of the chest wall are rare and present unique challenges, particularly when they recur and extend into the thoracic cavity. This case contributes to the limited surgical literature on the management of chest wall SFTs with significant intrathoracic involvement. Understanding the complexities and potential for recurrence in such cases is crucial for improving surgical outcomes and patient care.

Case presentation: A 63-year-old woman presented with a recurrent mass in the upper left breast, initially treated surgically in 2018. The mass reappeared in 2021, causing pain and shortness of breath. Clinical examination revealed diminished breath sounds on the left side, and imaging studies identified a large, complex chest wall tumor with intrathoracic extension.

Clinical discussion: The patient was diagnosed with a recurrent, extended intrathoracic chest wall SFT. She underwent thoracotomy for tumor resection, which was challenging due to dense vascular adhesions. The tumor was successfully removed with an estimated blood loss of 1100 mL. Postoperative recovery was uneventful, and histopathological analysis confirmed the diagnosis of SFT, with low proliferative activity on immunohistochemistry. The patient was discharged in good condition on postoperative day 7.

Conclusion: This case highlights the importance of comprehensive imaging, meticulous surgical planning, and long-term follow-up in managing recurrent chest wall SFTs. The successful outcome reinforces the value of a multidisciplinary approach in treating rare and complex tumors. Vigilance in monitoring for recurrence and ensuring clear resection margins are essential take-away lessons from this case.