Analysis of misdiagnosis of 38 cases of solitary fibrous tumor of the pleura

Abstract

To improve the preoperative diagnostic rate of solitary fibrous tumor(SFTP) of the pleura through the analysis on clinical characteristics and misdiagnosis reasons of SFTP. A retrospective review of the clinical records of 38 cases of SFTP in our hospital from January 2004 to June 2014 was conducted. The follow-up data were also reviewed. There were 18 males and 20 females, aging from 20 to 78 years (median, 53.8 years). Twenty-one cases were asymptomatic while other 17 had cough, chest pain, chest tightness and other symptoms. The levels of serum tumor markers were normal in 28 cases. The preoperative diagnosis was lung cancer in 9 cases, pleural mesothelioma in 5, neurofibroma in 5, pulmonary benign tumors in 4, pulmonary infection in 3, inflammatory granuloma in 5, pyothorax in 2, tuberculous pleuritis in 3, and pulmonary sequestration in 2 cases. The misdiagnosis rate was 84.4%, with misdiagnosis time ranging from 7 days to 10 years (median, 5.4 months). All the patients received thoracic surgical treatment. Among them, 33 cases were diagnosed as benign SFTP while 5 were diagnosed as malignant SFTP. Follow-up periods ranged from 1 to 118 months (median, 45 months). Three cases were lost, 2 died 11 months and 18 months after operation, and 3 reported recurrence. SFTP is a rare tumor which can be misdiagnosed easily. Awareness of its presentation and clinical course may help the clinician to consider referral to the thoracic surgeon for resection.