A Case of Giant Malignant Solitary Fibrous Tumor with Massive Pulmonary Invasion

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Background. Solitary fibrous tumors (SFT) are uncommon spindle cell neoplasms arising from undifferentiated mesenchymal cells. They usually present as pedunculated masses attached to the visceral pleura with benign histologic features. Case. A 62-year-old woman presenting with cough and dyspnea was referred to our institution for treatment of a giant tumor, occupying the right hemithorax, detected on a chest computed tomography. Though the definitive diagnosis was not obtained preoperatively, the patient underwent emergency surgery since she suffered from severe dyspnea caused by compression of the heart and lung due to the giant tumor. We had to perform right pneumonectomy because of the massive tumor invasion of the lung parenchyma. Grossly, the tumor with a maximum dimension of 25 cm arising from interlobar pleura, infiltrating deeply into the lung parenchyma, and invading the truncus intermedius and pulmonary artery. Histologically, the lesion showed a proliferation of spindle cells arranged haphazardly with myxoid stroma. The tumor had increased mitotic activity, necrosis, and hemorrhage. Immunohistochemical staining showed that tumor cells were positive for CD34, bcl-2, and negative for AE1/AE3, S-100, and α-smooth muscle actin. The tumor was diagnosed as a malignant SFT. Conclusion. We encountered a rare case of giant SFT which presented with massive pulmonary invasion and malignant histological features. Immunohistochemical examinations were useful for definitive diagnosis.

A Case of Giant Malignant Solitary Fibrous Tumor with Massive Pulmonary Invasion

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