Intrapericardial localization of solitary fibrous tumour: a case report.

Background: A solitary fibrous tumour (SFT) is a rare fibroblastic tumour, with primary cardiac SFT extremely rare. We report a rare case of a patient presenting with sudden dyspnoea who was diagnosed with a primary cardiac SFT.

Case summary: A 56-year-old woman with a history of diabetes and active smoking presented with sudden dyspnoea. Computed tomography scan revealed a mass adjacent to the left ventricle. In addition to the large pericardial effusion, no signs of cardiac tamponade or valvulopathies were found on echocardiography. The patient underwent open-heart surgery and mass removal, finding a tumour located inside the pericardial sac and attached to the left ventricle's lateral wall; it did not invade other heart structures. Histological and immunohistochemical examination of the mass revealed SFT diagnosis. The patient was discharged from the hospital in full health, and follow-up examinations revealed no evidence of tumour recurrence.

Discussion: Solitary fibrous tumour most commonly occurs in middle-aged patients and is not gender specific. Multimodal imaging is crucial for diagnosing and managing SFT. A definitive diagnosis must be based on both immunohistochemical and histopathological findings. STAT6 immunoexpression is the most reliable marker for histopathology diagnosis. Given the high SFT recurrence rate, follow-up is essential.