Solitary fibrous tumour of the chest wall. Progression beyond percutaneousradiotherapy

History and clinical findings: A 81-year-old patient free of pain was refer red to the university hospital for further evaluation and therapy of tumour masses in the right thorax. Clinical examination revealed dullness to perc ussion and reduced breathing in the right lower lung. Investigations: Computed tomography showed an enlarged solid tumour mass at tached to the thoracic cavity and pleural effusion on the right side, Quant ification of pulmonary perfusion presented significant defects in the right upper and middle lobe. Diagnosis, treatment and course: The pulmonary masses were biopsied under C T-guidance. Biopsy and immunohistochemical findings proved a malignant soli tary fibrous tumour of the chest wall, a mesenchymal tumour of its own enti ty. Because of pain in the right arm and because of missing oher reliable t herapeutic options a palliative irradiation was performed. The tumour did i ncrease in size due to radiotherapy and a severe right ventricular haertfai lure occured. The patient died 5 months after diagnosis has been made. Auto psy revealed a transition of tumour cells to sarcomatic growth. Conclusion: In our case we conclude an accelerated progression of the solit ary fibrous chest wall tumour in the course of irradiation. Whether the dev elopment of sarcomatic growth occured as a result of radiohterapy remains s peculative.