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CC BY-NC-ND 4.0 · Revista Argentina de Radiología / Argentinian Journal of Radiology 2021; 85(04): 098-105
DOI: 10.1055/s-0040-1721344
Comunicación Breve

Tumor fibroso solitario gigante de pleura. Serie de casos

Giant Solitary Fibrous Tumor of the Pleura. Case Series
Laura Marcela Fino-Velásquez
1   Facultad de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
,
Paulina Ojeda-León
2   Departamento de Patología, Hospital Universitario Mayor Mederi Universidad del Rosario, Bogotá, Colombia
,
Julio César Granada-Camacho
3   Departamento de Cirugía de Tórax, Hospital Universitario Mayor Mederi Universidad del Rosario, Bogotá, Colombia
,
Mario López-Ordoñez
3   Departamento de Cirugía de Tórax, Hospital Universitario Mayor Mederi Universidad del Rosario, Bogotá, Colombia
,
Mónica Parrado-Delgado
3   Departamento de Cirugía de Tórax, Hospital Universitario Mayor Mederi Universidad del Rosario, Bogotá, Colombia
,
Jorge Alberto Carrilo-Bayona
4   Departamento de Radiología, Hospital Universitario Mayor Mederi Universidad del Rosario, Bogotá, Colombia
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Resumen

Introducción El tumor fibroso solitario de pleura (TFSP) es una neoplasia poco frecuente, con aproximadamente 1.000 casos reportados en la literatura mundial. La aproximación diagnóstica inicial se realiza con estudios imagenológicos.

Métodos De forma retrospectiva, se recopilaron cuatro casos de pacientes con TFSP gigante operados en nuestra institución. Se describen las características sociodemográficas, clínicas, imagenológicas, macroscópicas y microscópicas de cada caso.

Resultados Todos los pacientes de la serie cursaron con manifestaciones clínicas, con un promedio de 23,75 meses de evolución. El 50% de los tumores se localizaron en la cavidad pleural derecha y el 50% en la izquierda. En tomografía computarizada (TC) de tórax, los cuatro casos se presentaron como una masa sólida, de densidad heterogénea, con diámetros mayores entre 17 y 22 cm y contornos variables (lisos en tres casos y lobulados en un paciente). Se observaron calcificaciones intratumorales en dos casos y derrame pleural en tres pacientes. En cirugía, todas las masas presentaron pedículos. El análisis histológico e inmuno-químico confirmó la naturaleza benigna de tres casos y malignidad en una de las neoplasias.

Conclusiones Los TFSP generalmente son benignos y de buen pronóstico. Sin embargo, entre 10 y 20% de esos tumores son malignos. Las imágenes diagnósticas pueden sugerir el diagnóstico de TFSP, pero la confirmación de la naturaleza de la lesión debe realizarse con el análisis histopatológico de toda la pieza quirúrgica.

Abstract

Introduction Solitary fibrous tumor of the pleura (SFTP) is a rare neoplasm, with ∼1.000 cases reported in the worldwide literature. The initial diagnostic approach is performed by imaging studies.

Methods Retrospectively, we collected four cases of patients with giant SFTP operated in our institution. The sociodemographic, clinical, imaging, macroscopic, and microscopic characteristics of each case are described.

Results All the patients in the series had clinical manifestations, with an average of 23.75 months of evolution. 50% of the tumors were located in the right pleural cavity and 50% in the left. In chest computed tomography (CT), the four cases presented as a solid mass, of heterogeneous density, with greater diameters between 17 and 22 cm, and variable contours (smooth in three cases and lobulated in one patient). Intratumoral calcifications were observed in two cases and pleural effusion in three patients. In surgery, all masses presented pedicles. The histological and immunochemical analysis confirmed the benign nature of three cases and malignancy in one of them.

Conclusions SFTPs are usually benign and have a good prognosis. However, between 10 and 20% of these tumors are malignant. Diagnostic images may suggest the diagnosis of SFTP, but confirmation of the nature of the lesion should be made with the histopathological analysis of the entire surgical specimen.

Palabras Clave

tumor fibroso solitario - pleura - neoplasia pleural

Keywords

solitary fibrous tumor - pleura - pleural neoplasm

Responsabilidades Éticas

Protección de personas y animales. Los autores declaran que para esta investigación no se han realizado experimentos en seres humanos ni en animales.


Confidencialidad de los datos. Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicación de datos de pacientes.


Derecho a la privacidad y consentimiento informado. Los autores declaran que en este artículo no aparecen datos de pacientes.




Publication History

Received: 11 December 2017

Accepted: 20 July 2020

Article published online:
29 March 2021

© 2021. Asociación Civil Sociedad Argentina de Radiología and Federacion Argentina de Asociaciones de Radiología, Diagnóstico por Imágenes y Terapia Radiante. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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