Clinical behavior of solitary fibrous tumors of the pleura

Brackground. Solitary fibrous tumors of the pleura are rare and present unp redictable clinical behavior. Methods. Between 1981 and 1998, 11 solitary fibrous tumors of the pleura we re resected in 10 patients at the University Hospital of Geneva. Their clin ical behavior and outcome were reviewed. Results. Seven tumors arose from the visceral pleura, and three arose from the parietal pleura. Tumors arising from the parietal pleura were revealed to be more difficult to resect than those from the visceral pleura because of their size and adhesion to the chest wall requiring extrapleural resecti on. Eight tumors showed benign features, whereas two showed distinct featur es of malignity. One additional patient presented marked pleomorphism that could represent an intermediate form before frank malignity. Four tumors ha d been followed expectandly for 2 to 10 years before surgery. Although thre e enlarged rapidly, no signs of malignity were observed on hisiological exa mination. All patients are alive, from 2 months to 14 years after surgery ( mean 55 months). In one case, however, a malignant tumor recurred 6 years a fter resection of a benign variant. Conclusions. Although histologically benign, solitary fibrous tumors of the pleura may enlarge rapidly and occasionally transform into malignant varia nts after several years. Therefore, complete surgical resection and long-te rm follow-up is recommended for all patients. (Ann Thorac Surg 1999;67:1456 -9) (C) 1999 by The Society of Thoracic Surgeons.