Intrapulmonary location of benign solitary fibrous tumor

Our plain-English summary of Intrapulmonary location of benign solitary fibrous tumor, by Z.M. Alghamdi, S.A. Othman, M.J. Al-Yousef, et al (Annals of Thoracic Medicine, 2020).

The study

• Authors: Z.M. Alghamdi, S.A. Othman, M.J. Al-Yousef, B.Z. AlFadel
• Journal: Annals of Thoracic Medicine
• Published: 2020;15(2):98-101
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Intrapulmonary solitary fibrous tumors (SFTs) are sporadic mesenchymal neoplasms that typically arise from visceral or parietal pleura. While accounting for <5% of all pleural tumors, SFTs are known to occur in nearly all bodily organs, including nasopharynx, bladder, prostate, soft tissue of neck, buttocks, extremities, and abdominal wall. Such tumors have been previously designated localized fibrous mesothelioma or pleural fibroma. SFTs have no genetic basis and are unrelated to environmental factors such as tobacco smoking or asbestos exposure. Herein, we describe a 24-year-old woman whose clinical presentation mimicked atypical carcinoid tumor. A diagnosis of intrapulmonary SFT was achieved by surgical resection.

Copyright: © 2020 Annals of Thoracic Medicine.

In plain English

This was a case report of one patient, a 24-year-old woman, written by authors at Imam Abdulrahman Bin Faisal University in Saudi Arabia. She had had intermittent left chest pain for 10 months, along with cough, shortness of breath, fever, nausea, vomiting, diarrhea, facial flushing and weight loss. She was a nonsmoker. A CT scan showed a 4.0 cm × 3.3 cm mass in the lower lobe of her left lung. Her symptoms and scan suggested a carcinoid tumor. After surgeons removed that lobe using video-assisted thoracoscopic surgery, tissue tests showed a solitary fibrous tumor inside the lung, and ruled out other tumors, including mesothelial tumors. She went home five days after surgery. The article did not report any asbestos exposure for this patient. As background, it stated that these tumors, once called localized fibrous mesothelioma, are unrelated to asbestos exposure. The authors concluded that this rare tumor often escapes diagnosis before surgery and needs close long-term follow-up.

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 (one patient)
• Who was studied: One 24-year-old woman, a nonsmoker, seen at an outpatient clinic; the authors are from Imam Abdulrahman Bin Faisal University, Saudi Arabia. No dates of care are given.
• Exposure: No asbestos exposure was studied or reported for this patient. The article states, as background, that solitary fibrous tumors (previously called localized fibrous mesothelioma or pleural fibroma) are unrelated to tobacco smoking or asbestos exposure.
• Main results:
  • Contrast-enhanced CT showed a mass in the patient's left lower lobe measuring 4.0 cm × 3.3 cm.
  • The patient's CT findings and symptoms suggested carcinoid tumor, which was disproven after surgery.
  • The patient underwent video-assisted thoracoscopic removal of the left lower lobe under general anesthesia.
  • The tumor showed no visible necrosis, and mitoses were infrequent.
  • The tumor cells stained positive for CD34 and Bcl-2 and negative for smooth muscle actin, S100 protein and Wilms tumor-1.
  • These features confirmed solitary fibrous tumor and ruled out leiomyoma, peripheral nerve sheath tumors and mesothelial neoplasms.
  • The patient's recovery right after surgery was uneventful, and she was discharged on postoperative day 5.
• The authors' conclusion: The authors concluded that intrapulmonary solitary fibrous tumor is a rare variant of pleural solitary fibrous tumor that often eludes diagnosis before surgery. They also concluded that, despite a frequently benign course, such tumors warrant close extended follow-up.

Topics

Medical terms in this study, explained in our Lexicon: Solitary Fibrous Tumor, Neoplasm, Parietal Pleura, Mesothelioma, Asbestos Exposure, Surgical Resection.

Related studies

• Solitary benign fibrous tumors of the pleura — M.A. Regal, A.M. Al Rubaish, et al. (2008)
• Patterns of chromosomal imbalances in benign solitary fibrous tumours of the pleura — M. Krismann, H. Adams, et al. (2000)
• Solitary benign fibrous mesothelioma of the peritoneum: A rare entity in a 2-year-old child — S. Singh, M. Sangwan, et al. (2016)
• Intrapulmonary localized fibrous tumor. Intraparenchymal so-called localized fibrous mesothelioma — S.A. Yousem, S.D. Flynn (1988)
• Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics — L.A. Doyle, M. Vivero, et al. (2014)
• Solitary fibrous tumor of the mediastinum. A report of 14 cases — G.B. Witkin, J. Rosai (1989)

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