Disease Definition: Solitary fibrous tumor (SFT), also known as fibrous tumor of the pleura, is a rare mesenchymal tumor originating in the pleura or at virtually any site in the soft tissue including seminal vesicle. Approximately 78% to 88% of SFT's are benign and 12% to 22% are malignant. It is a heterogeneous group of rare spindle-cell tumors that include benign and malignant neoplasms. Their cell of origin is still debated. SFT is preferred by most pathologists as a better term than “hemangiopericytoma” that gathers numerous unrelated entities and is presently only employed by neuropathologists. We focus the present paper on the forms of this family of tumors occurring in adult patients. There are 3 typical primary locations: pleural, meningeal and extrathoracic soft tissue.
Disease Symptoms: Patients present with proptosis and possibly ptosis, eyelid swelling, tearing, diplopia or decreased vision. Malignant infiltrating lesions can sometimes cause pain.
Disease Treatment: Because even benign-appearing solitary fibrous tumors (SFTs) can be locally recurrent and metastatic, wide resection of both benign and malignant SFTs is recommended. Preoperative vascular studies and arterial embolization should be considered because of the known bleeding risk with resection. Careful exclusion of other diagnoses (eg, synovial sarcoma) is important. Because of the favorable outcome with SFTs, it may be possible to avoid limb-threatening and deforming operations. No evidence suggests that adjuvant chemotherapy is beneficial. If the SFTR appears malignant histologically, adjuvant radiation therapy may be considered. Long-term follow-up is recommended because local and distant relapse is possible, even with benign-appearing tumors.
Statistics: The objective of this study is to present 17 new cases of SFTP and analyze the morphological characteristics that help to identify tumors with a malignant behavior. A retrospective review of the patients who had primary pleural tumors from January 1995 to August 2010. Among a total of 94 primary pleural tumors, 17 patients were enrolled in this study, 8 men and 9 women, with a mean age of 63 years. Thirteen cases (76%) were benign and four cases (23%) were malignant. Local recurrences occurred in three cases. There were no metastases found. Recurrences occurred only in malignancy tumors. All malignant tumors were high cellularity and had hemiangiopericitic pattern, more than 4 mitoses per 10 high power fields, and moderate to marked polymorphism. SFTP shows a benign biologic outcome in most of the cases.