Solitary benign fibrous tumors of the pleura

Our plain-English summary of Solitary benign fibrous tumors of the pleura, by M.A. Regal, A.M. Al Rubaish, Y.F. Al Ghoneimy, et al (Asian Cardiovascular & Thoracic Annals, 2008).

The study

• Authors: M.A. Regal, A.M. Al Rubaish, Y.F. Al Ghoneimy, R.I. Hammad
• Journal: Asian Cardiovascular & Thoracic Annals
• Published: 2008;16(2):139-42
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Solitary benign fibrous tumors of the pleura are very rare. Seven patients (mean age, 52 years) who presented between 1995 and 2005 were studied retrospectively. They had nonspecific chest symptoms and no history of asbestos exposure or smoking. Chest radiography showed a large opacity occupying most of the affected hemithorax, with clear costophrenic angles. Computed tomography of the chest showed a large well-delineated heterogeneous mass directly related to the lateral chest wall. Needle biopsy suggested the benign nature of the lesion. Surgery was performed through a posterolateral thoracotomy. Five tumors arose from visceral pleura, and 2 from parietal pleura. The mean tumor diameter was 7.5 cm (range, 8-14 cm). Complete surgical excision was carried out in all cases. Histopathology and immunohistochemical staining confirmed the benign nature of the tumors. There was no mortality or major complication. The mean follow-up period was 4 years (range, 1-10 years). All patients remained tumor-free during follow-up. Wide local excision, including pulmonary and pleural resection, is recommended as the best therapeutic option.

In plain English

This article was a retrospective review of the medical charts of 7 patients who had surgery for solitary benign fibrous tumors of the pleura between 1995 and 2005 at Mansoura University Hospital, Egypt, and King Fahd Specialist Hospital, Saudi Arabia. Four were men and 3 were women, with a mean age of 52 years. The authors reported that none had asbestos exposure. Fine-needle aspiration was not helpful. Tru-Cut needle biopsy suggested a benign tumor in 4 patients and was inconclusive in 3. Five tumors arose from the visceral pleura and 2 from the parietal pleura. All were completely removed, and one patient needed a lobectomy. Under the microscope all tumors showed the features of solitary fibrous tumor. All stained positive for CD34, a marker that helps tell these tumors apart from mesothelioma. There were no deaths or major complications. Over a mean follow-up of 4 years (range 1 to 10), all patients remained tumor-free. The authors concluded that wide local excision, including pulmonary and pleural resection, is the best treatment. The tumor sizes the article reports contradict each other.

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: Retrospective case series (review of medical charts of operated patients)
• Who was studied: 7 patients (4 male, 3 female; mean age 52 plus or minus 7 years) operated on for solitary benign fibrous tumors of the pleura between 1995 and 2005 at Mansoura University Hospital, Egypt, and King Fahd Specialist Hospital, Saudi Arabia
• Exposure: No exposure was studied. The authors state that none of the patients had asbestos exposure.
• Main results:
  • Preoperative biopsy: fine-needle aspiration cytology was not helpful. Tru-Cut biopsy suggested a benign lesion in 4 of the 7 patients and was inconclusive in 3.
  • Of the 7 tumors, 5 arose from the visceral pleura and 2 from the parietal pleura.
  • Complete surgical excision was achieved in all 7 patients.
  • One of the 7 patients required a lobectomy because the tumor had a wide base.
  • On microscopy, all tumors showed the classic features of solitary fibrous tumor of the pleura.
  • CD34 staining, which helps distinguish solitary fibrous tumor from mesothelioma, was positive in all cases.
  • One tumor was non-pedunculated, larger than 10 cm and arose from the parietal pleura over the chest wall, but it proved benign on histopathology.
  • The article reports tumor diameters of 8 to 14 cm with a mean of 7.5 cm. A mean below the smallest value is impossible, so these figures cannot both be correct.
  • There were no deaths and no major complications after surgery.
  • Mean follow-up was 4 years (range 1 to 10 years), with no patient lost to follow-up.
  • Based on clinical and radiological checks, all 7 patients remained tumor-free during follow-up.
• The authors' conclusion: The authors concluded that wide local excision, including pulmonary and pleural resection, is the best treatment option.

Topics

Medical terms in this study, explained in our Lexicon: Pleura, Asbestos Exposure, Hemithorax, Costophrenic angle, Needle Biopsy, Thoracotomy, Visceral Pleura, Parietal Pleura.

Related studies

• Solitary fibrous tumor of the pleura — A. Orki, A. Kosar, et al. (2008)
• Benign localized fibrous tumor of the pleura: report of 25 new cases — S. Enon, D. Kilic, et al. (2012)
• Huge malignant solitary fibrous tumor of the pleura — W.A. Arab, D. Lamoth, et al. (2012)
• Solitary fibrous tumors of the pleura: a case report and review of the literature — P. Mordenti, R. Di Cicilia, et al. (2013)
• Solitary fibrous tumor of the pleura: 3 case reports — E. Amorim (2015)
• Solitary fibrous tumors of the pleura: an estimation of population incidence — T. Thorgeirsson, H.J. Isaksson, et al. (2010)

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