Extrapericardial solitary fibrous tumour of the pericardium

Our plain-English summary of Extrapericardial solitary fibrous tumour of the pericardium, by S.M. Andreani, L. Tavecchio, R. Giardini, et al (European Journal of Cardio-thoracic Surgery, 1998).

The study

• Authors: S.M. Andreani, L. Tavecchio, R. Giardini, A.V. Bedini
• Journal: European Journal of Cardio-thoracic Surgery
• Published: 1998;14(1):98-100
• Type of article: Case report
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Solitary fibrous tumour (SFT) occurs most commonly in the pleura and is extremely rare in the pericardium. The authors report a case of a 60-year-old man in whom a large mediastinal mass was accidentally discovered. Computed tomography showed involvement of the left anterosuperior mediastinum with displacement of the trachea, large vessels and oesophagus; histopathological findings after complete resection of the neoplasia demonstrated an SFT of the pericardium, the first reported case with extrapericardial pattern of growth. A review of the literature on SFTs of the pericardium is provided.

In plain English

This was a case report from the National Cancer Institute in Milan, Italy, describing one patient with a solitary fibrous tumour (SFT) of the pericardium, the sac around the heart. The authors note that SFT is also called localized fibrous tumour or fibrous mesothelioma. The patient, a 60-year-old man with no history of occupational exposure to asbestos, had a large chest mass found by chance on a routine X-ray. A CT scan showed the mass pushing aside the windpipe, gullet and major blood vessels and narrowing the windpipe. A needle biopsy found a spindle cell tumour without evidence of malignancy. Surgeons removed the entire tumour, which measured 20 by 18 cm and weighed 1615 g, together with a vein, nerves and nearby tissue. A second operation was needed for bleeding. Four years later he had no sign of recurrence. The authors described this as the fifth reported pericardial SFT and the first growing outside the pericardial sac. They concluded that complete removal is advisable because the disease's behaviour is unpredictable, and that long follow-up is needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient), with a brief discussion of previously reported cases
• Who was studied: one 60-year-old man treated at the Department of Thoracic Surgery, National Cancer Institute, Milan, Italy, whose left mediastinal mass was found by chance on a routine pre-operative chest X-ray done for a herniated intervertebral disc; dates of treatment not given
• Exposure: the patient had no history of occupational exposure to asbestos; no other exposure was studied
• Main results:
  • CT showed a large anterosuperior mediastinal mass displacing the oesophagus, the left common carotid and left subclavian artery, and the trachea, whose lumen was reduced
  • Fine needle aspiration biopsy found a spindle cell tumour without evidence of malignancy
  • The tumour was completely removed through a median sternotomy, which required resecting the left innominate vein; no residual tumour was left
  • A resternotomy was needed for bleeding a few hours after surgery; there were no further post-operative complications
  • The removed mass measured 20 × 18 cm and weighed 1615 g
  • Mitoses were rare, averaging two per ten high-power fields
  • The tumour cells were positive for vimentin and CD34 and consistently negative for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, desmin, actin and S100 protein
  • Four years after surgery the patient had no symptoms and no evidence of local or distant recurrence
  • The authors reported this as the first case of SFT of the pericardium with growth outside the pericardial sac. Three of the four earlier pericardial cases grew within the sac, and the growth pattern of the fourth could not be determined.
• The authors' conclusion: The authors concluded that, because the clinical behaviour of SFT is unpredictable, complete excision is always advisable even if it means sacrificing nerves or vessels. They added that local recurrence can occur many years later, so long follow-up is required.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pericardium, Pleura, Mediastinum.

Related studies

• Primary tumors and cysts of the heart and pericardium — H.A. McAllister (1979)
• Primary malignant mesothelioma of the pericardium. Case report and literature review — R. Thomason, W. Schlegel, et al. (1994)
• Malignant mesothelioma arising after direct application of asbestos and fiber glass to the pericardium — A. Churg, M.L. Warnock, et al. (1978)
• Primary malignant mesothelioma of the pericardium — J. Patel, M.N. Sheppard (2011)
• Malignancies involving the pericardium — W.H. Warren (2000)
• Letter: Mesothelioma of the pericardium with cholesterol pericarditis — E. Argianas, K. Melissinos, et al. (1974)

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