Solitary Fibrous Tumours (SFTs) of Pleural and Lungs; rare yet challenging from a surgical and clinical aspect

Abstract

Introduction: Solitary Fibrous Tumours of pleura and lungs are rare neoplasms of mesenchymal origin. Initially they were reported only in pleura but their incidence has been reported in other sites.

Aim: To present a tertiary centre experience in the surgical management of SFTs case series.

Materials and Methods: Retrospective study (2008-2015) of SFTs managed in a tertiary thoracic surgery department. Medical records, imaging and pathology were reviewed.

Results: During 2008-2016, 9 cases of SFTs underwent surgery in our Department. 6/9 males, mean patient age 58 years. 2/9 patients’ initial presenting complaint was chest pain whereas 7/9 were asymptomatic and were referred to our Service as ?Lung Cancer due to incidental abnormal radiological findings. 1/9 cases underwent a heart transplant 2 years before referral to us. Histological confirmation prior to surgery with CT guided biopsy was done in 2/9 cases. Diameter range of the tumours was 4.5-8.5 cm. 6/9 SFTs arose from the parietal pleura, 2/9 from visceral pleura and 1 was intraparenchymal. VATS excision in 7/9 cases and 2/9 had mini thoracotomy. Mean hospital stay:3 days. Mortality 0%. Pathology confirmed SFTs but 1/9 cases presented malignant potential due to the presence of 2 mitosis. Mean follow up of all patients was 5.5 years and there was no recurrence/malignancy recorded.

Conclusion: SFTs constitute a rare clinical entity and often trigger lung cancer pathway referrals. Sharing the experience in these cases is beneficial for all specialties involved in their diagnosis and management. They are not limited to pleura only but can also arise from the lung. No recurrence is recorded during extended follow up.