Occult solitary fibrous tumour of the pleura presenting as recurrent spontaneous pneumothorax

BMJ Case Rep. 2024 Mar 19;17(3):e257161. doi: 10.1136/bcr-2023-257161.

Abstract

A woman in her 30s, non-smoker, presented at the emergency department two times because of spontaneous pneumothorax. The first episode was treated with small bore catheter drainage, while during the second episode-occurring only 1 week later-thoracoscopic talcage was attempted. The postoperative course was characterised by slow clinical and radiological resolution, and recurrence 3 days after discharge. Eventually, multiportal video-assisted thoracoscopic exploration identified an interfissural solid mass. Resection and further work-up revealed the diagnosis of 'low-risk' solitary fibrous tumour (SFT) stage pT1N0M0. The interdisciplinary tumour board advised no adjuvant therapy. A CT thorax was scheduled in 1 year for follow-up. The patient was discharged without complications and has had no recurrences of pneumothorax at 6 months of follow-up. This report shows that SFT can easily be missed on initial presentation and should be considered in the differential diagnosis of pneumothorax, especially when frequently recurring.

Keywords: respiratory cancer; respiratory medicine.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Hemangiopericytoma* / complications
  • Humans
  • Neoplasm Recurrence, Local / complications
  • Neoplasm Recurrence, Local / surgery
  • Pleura / surgery
  • Pneumothorax* / diagnostic imaging
  • Pneumothorax* / etiology
  • Recurrence
  • Solitary Fibrous Tumor, Pleural* / diagnosis
  • Solitary Fibrous Tumor, Pleural* / diagnostic imaging
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracoscopy