Solitary Fibrous Tumors of the Chest: Case Series from a Portuguese Center

Abstract

The solitary fibrous tumor is a rare mesenchymal tumor with predilection for the pleura. Most times it is an incidental diagnosis. Surgery is the recommended treatment. Most solitary fibrous tumors (SFTs) exhibit indolent behavior; however, 10% to 25% may experience recurrence. The aim of this retrospective analysis is to characterize their presentation, therapeutic approach and recurrence and was conducted at the Pulmonary Oncology Department in Unidade Local de Saúde Santa Maria, in Lisbon, Portugal, between May 2013 and December 2023. We identified nine patients, 66,7% male, median age 66 years. The average tumor size was 14.5 cm; 88.9% located in the pleura. Surgical intervention was proposed for eight patients, of whom seven underwent the procedure. Four patients had disease recurrence, three underwent new surgery and one died. One of these three patients underwent post-operative radiotherapy. Again, these three patients suffered a relapse, one underwent surgery and two started systemic therapy. At the time of cut-off, five patients were alive, and four were progression-free. The solitary fibrous tumor is a rare and underdiagnosed entity, which justifies the small number of patients, and its malignant potential is poorly recognized. Our findings are consistent with those reported in the existing literature; however, we observed a higher proportion of tumors exhibiting malignant characteristics. The high prevalence of recurrence is explained by the fact that only complex or previously recurrent cases are referred for discussion at our center.