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Neumología y cirugía de tórax

Print version ISSN 0028-3746

Abstract

RIOS-PASCUAL, Silviano et al. Fibrous solitary tumor of the pleura: Factors associated with malignant behavior and relapse. Institutional experience. Neumol. cir. torax [online]. 2019, vol.78, n.1, pp.25-31.  Epub Nov 09, 2020. ISSN 0028-3746.

Introduction:

The fibrous lone tumor of the pleura represents less than 5% of the primary pleural tumors, from 12 to 32% can have malignant behavior with local recurrence and metastasis. The diagnostic study of choice is the computed tomography of thorax. Most originate in the visceral pleura and are pediculated. The treatment is surgical resection en bloc due to the high probability of recurrence, with margins of 1-2 cm. 9% of cases have recurrence.

Objectives:

Identify factors related to malignant behavior and recurrence.

Material and methods:

Observational, descriptive, retrospective and transversal study. All patients undergoing resection of TFSP are included in the National Institute of Respiratory Diseases, from January 2008 to December 2017.

Results:

26 patients are included, most frequently pediculated tumors dependent on the visceral pleura, 92% manifested symptoms, mainly dyspnoea. Eighteen benign and eight malignant, of which two relapsed, there was death associated with the tumor in two cases.

Conclusions:

The factors related to malignant behavior were the presence of general symptoms (p = 0.013), weight loss greater than 10 kg in the last six months (p = 0.004) and invasion of adjacent structures (p = 0.020). The factors related to recurrence were the presence > 4 mitoses/10 high power fields (p = 0.018), weight loss greater than 10 kg in the last six months (p = 0.046), invasion of adjacent structures (p = 0.030) and suboptimal surgical resection (p = 0.003). Fibrous lone tumor of the pleura is a tumor of uncertain biological behavior, therefore, factors associated with malignancy and recurrence should be investigated. The treatment is surgical resection en bloc and if malignancy or recurrence criteria are present, adjuvant therapy is required.

Keywords : Fibrous solitary tumor of the pleura; pleural neoplasms; malignancy; relapse.

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