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Background Solitary fibrous tumours of the pleura (SFTP) are rare and account for around 5% of pleural based tumours with rates of malignancy of around 30%. Published data primarily includes histologically proven SFTP, but there is little evidence regarding the outcomes of radiologically diagnosed SFTP. Methods A service evaluation of radiologically diagnosed SFTP was completed in 12 UK centres, searching the local radiology database reports for the terms ‘Pleural fibroma’ OR ‘fibrous tumour of the pleura’ OR ‘SFTP’ between 01/01/2005 and 31/12/2015. Scans were determined to demonstrate a ‘typical’ SFTP, ‘unlikely’ SFTP or SFTP that was ‘within the differential diagnosis’. Data were collected to establish subsequent diagnoses and what follow up was undertaken. Results A total of 246 cases were included, table 1 exhibits the outcomes in each radiological group. Of patients with typical appearances for SFTP, 20/44 were histologically confirmed to represent a fibroma, 19/44 underwent radiological follow up only and 4/44 were confirmed not to represent SFTP. Of the patients who underwent radiological follow-up; there were 9 deaths, none of which were known to be related to SFTP, the median longest diameter was 30 mm (IQR 25–40) and the median follow-up time was 62 months (IQR 17–106). Of the 61 cases histologically confirmed SFTP, 17/61 were malignant, 37/61 benign and 7/61 unknown. A total of 26 patients died, 5 secondary to SFTP, 12 unrelated to SFTP and 9 of unknown cause. Conclusion A large proportion of patients with radiologically typical SFTP features do not undergo biopsy or resection and did not have SFTP related adverse outcomes in this small series. Further analysis is needed to determine whether any radiological features can predict clinical outcomes.

ZusammenfassungDie Abklärung der Belastungsdyspnoe stellt eine wichtige und differenzialdiagnostisch vielfältige Aufgabe des Pneumologen dar. Wir berichten von einer zum Zeitpunkt der Erstvorstellung 70-jährigen Patientin mit einem nahezu den kompletten linken Hemithorax ausfüllenden Tumor. Histologisch konnte ein solitäres Pleurafibrom diagnostiziert werden.

A 52 Year old male was admitted with respiratory distress. Radiological examination revealed a large mass in patient's right hemi thorax with mediastinal shift and partial lung collapse. Biopsies previously done conferred the diagnosis of solitary fibrous tumor; however, in order to avoid a surgical resection, patient didn't follow the adviced procedure. After thorough counseling, surgical resection was done with few post operative complications and patient recovered well with ability to perform his daily activities with partial support. The histopathology results showed solitary fibrous tumor. Apart from pneumonia and local wound infection, patient status was well for the next six week follow-up.

Solitary pleural fibrous tumour is not a common tumour to present early; it is of a fibroblastic origin. As they are highly vascular tumours, they carry significant risk of intra-operative haemorrhage and warrant difficult haemostasis. Surgical resection of such tumours is the standard and conventional treatment and most of them tend not to reoccur. We report a case of giant pleural fibroma with recurrence of more than three times despite resection via thoracotomy on first instance and two sternotomies.

Solitary fibrous tumours of the pleura are usually benign. However, malignancy is observed in 13% of the cases. The authors report two cases of 27 and 69 year-old patients, presenting chest pain and dyspnoea. The roentgenograms and computed tomography scanning revealed a pleural tumour in both cases. The patients underwent complete resections of these tumours. The immunohistochemical study confirmed the diagnosis of malignant solitary pleural fibroma. The patients succumbed to their disease secondary to local recurrences. Histopathology is very helpful in the diagnosis of malignant pleural fibroma. Surgery and long-term follow-up are mandatory.

Solitary fibrous tumor of the pleura (previously known as benign fibrous mesothelioma or pleural fibroma) can have a wide variety of appearances on imaging examinations. This essay reviews some of the lesion's more dramatic features.

Fibrous tumour of the pleural is rare and controversial tumor. Most of the reported cases is adults and the elderly. This case presentation is a solitary fibrous tumour in a fifteen year old girl, which to the best of our knowledge is the youngest report, who was sent for a psychiatric evaluation due to persistent complaint of "movement" in her chest, later referred to a tuberculosis clinic because of a chest radiograph report of loculated pleural effusion likely secondary to tuberculosis. She eventually had a chest computerized tomography and subsequent resection of the lesion. Histology confirmed the computerized tomography diagnosis of solitary fibrous tumour and there was no recurrence five years after excision. This report highlights the difficulty often encountered in developing countries where clinicians solely rely on clinical acumen for diagnosis and treatment due to poor patients' financial status and scarcely available diagnostic resources.Pan African Medical Journal 2013; 14:16

Haufig finden sich in Routineaufnahmen des Thorax Lungenrundherde. Zumeist verbergen sich dahinter Bronchial-Karzinome, die haufigste maligne Erkrankung. Nur etwa 0,9% aller Lungentumoren sind gutartig, wobei Pleurafibrome am haufigsten sind. Sie treten in jedem Lebensalter auf (Mittel 50. Lebensjahr), und wachsen progredient. Eine maligne Entartung ist selten, aber Rezidive entstehen in 10-15% innerhalb von funf Jahren, die haufiger maligne sind. In unserem Fallbeispiel einer 34-jahrigen Patientin mit unspezifischer Atemnot fand sich ein rundovaler Tumor peripher im rechten Oberfeld. Die thorakoskopische Resektion bestatigte ein benignes submesotheliales Pleura-Fibrom.

We report the case of a 65-year-old woman who presents hypoglycemic symptoms before surgical ablation of a pleural fibroma. Several pathogenetic mechanisms, including tumoral production of insulin growth factor II or a precursor of this factor, are involved in the etiology of tumor induced hypoglycemia.

Scattini, C. M. and Orsi, A. (1973). Thorax , 28 , 782-787. Multiple bilateral fibromas of the pleura. A patient with multiple bilateral fibromas of the pleura which evolved over 25 years is presented. Tumours were resected in four successive surgical interventions during this period. At the second operation `spontaneous regression9 of several small pleural fibromas noted at the first operation four years previously was observed. The differentiation between pleural fibroma and pleural localized mesothelioma is discussed.

Pleural fibromata are rare tumours. We report a case of histologically proven pleural fibroma with later recurrence following resection. The case emphasizes the need for long-term review of patients with pleural fibromata.