Rapid growth of a solitary fibrous tumor of the pleura after slow long-term progression: A case report

Abstract Background: Solitary fibrous tumors (SFTs) of the pleura usually exhibit benign behavior. . We present a case of SFT of the pleura which grew rapidly after long term slow progression. Case presentation: A 78-year-old man was referred for left-sided back pain and shortness of breath. He had a left mediastinal mass which detected at the age of 15 year. Sixty years later, chest computed tomography (CT) revealed that the tumor was 8.0 cm in diameter and remained unchanged for 3 years. However, the tumor then increased to 15.8 cm over the next 3 years. Because the left main pulmonary artery was compressed by the mass, there was concern regarding worsening of hemodynamics, and the symptoms of respiratory distress became more severe. Sixth rib-bed intercostal thoracotomy with a posterolateral incision was performed for removing the large tumor. Perioperative steroid administration (methylprednisolone 125 mg/day) and positive pressure ventilation with were applied to prevent re-expansion pulmonary edema. The patient was discharged with uneventful course. The tumor was pathologically diagnosed as SFT without malignant findings. Conclusion: Because SFTs have a potential for rapid growth even if the SFTs show benign histological findings, surgical indication is desirable.