Rapid growth of a solitary fibrous tumor of the pleura after slow long-term progression: a case report.

Abstract

Background: Solitary fibrous tumors (SFTs) of the pleura are usually benign. We present a case of SFT of the pleura which grew rapidly after slow long-term progression.

Case presentation: A 78-year-old man was referred to our hospital for left-sided back pain and shortness of breath. He was found to have a left mediastinal mass at 15 years of age. He remained asymptomatic for 60 years, and chest computed tomography (CT) during treatment of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis revealed that the mediastinal tumor was 8.0 cm in diameter. The size remained unchanged for 3 years but increased to 15.0 cm over the next 5 years. As the left main pulmonary artery was compressed by the mass, there were concerns regarding the worsening of haemodynamics and exacerbation of symptoms of respiratory distress. A sixth-rib intercostal thoracotomy with a posterolateral incision was performed to remove the large tumor. Perioperative steroid administration (methylprednisolone 125 mg/day) and positive pressure ventilation were administered to prevent re-expansion of the pulmonary oedema. The patient was discharged following an uneventful course. The tumor was pathologically diagnosed as an SFT with no malignant findings.

Conclusion: SFTs require surgical intervention because of their potential for rapid growth.