Pleural solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm that accounts for less than 5% of all soft tissue tumors [1]. Although most SFTs are histologically benign, up to 12% may undergo malignant transformation. While typically solitary, multiple lesions are exceptionally rare [2]. Immunohistochemistry is essential for diagnosis and differentiation from other pleural neoplasms. Common markers include CD34 and STAT6 [1,3], and high p16 expression may indicate more aggressive behavior [5], justifying intensified monitoring. We present the case of a 69-year-old woman with no relevant medical history, who underwent complete resection in 2015 of a solitary right hemithorax SFT measuring 14.7cm×9cm, with no histological signs of malignancy. After seven years of annual surveillance, two right pleural lesions were detected, showing moderate uptake on positron emission tomography (PET) (SUVmax 3.06). Biportal right video-assisted thoracoscopic surgery (VATS) was performed, revealing 33 well-defined, non-infiltrative lesions (1.5–10cm) in the parietal and visceral pleura and pericardiophrenic fat (Fig. 1). Histopathology confirmed recurrence, with strong expression of CD34, STAT6, p16, and a Ki-67 index of 12%. Although most SFTs have a benign course, up to 25% may recur following resection [4]. Long-term follow-up is essential, particularly when immunohistochemical markers suggest possible aggressive potential.
All authors actively participated in the analysis of the case and in the writing and critical revision of the manuscript. All authors approved the final version.
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FundingThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interestsThe authors state that they have no conflict of interests.
