Calcifying fibrous tumor of the pleura: need for treatment?

Background Calcifying fibrous tumors of the pleura (CFTPs) are rare entity of pleural tumors, only a few case reports have been published. Surgical resection is the best treatment to confirm the diagnosis. Solitary or multiple lesions can be found in several locations of the human body, approximately 10% of all CFT cases have been reported in the pleura, first in 1996.

Methods & Materials During the retrospective period between January 2003 and December 2024 three patients underwent diagnostic resection of CFTPs. Clinical and histopathologic parameters were analyzed.

Results Two of the patients were female and one patient were male. Mean age was 50 ± 5.7 years. Video-assisted thoracoscopy was performed to identify masses located in the right lower lobe or in the right basal pleura with a maximum diameter of 1.8 cm. Two patients had multiple lesions which were only partially resected for diagnostic purposes. Histologically, cell-poor spindle cell proliferation with circumscribed calcifications was found. Immunohistologically the cell clusters showed no expression of ALK, smooth muscle actin, CD34, STAT6, nuclear beta-catenin, desmin, EMA or S100.

Conclusion The clinical and radiological presentation of calcifying fibrous tumors is non-specific, and the diagnosis is rarely made before surgical biopsy. Histological and immunohistochemical examination is usually required to confirm the diagnosis. Complete surgical resection is the gold standard, especially in the presence of symptoms. Recurrence is very rare. In the case of asymptomatic and small tumors, regular observation by computed tomography examination can be considered.

Publication History

Article published online:
25 August 2025