This case reports the largest known malignant solitary fibrous tumour of the pleura treated with en bloc surgical resection warranting the use of cardiopulmonary bypass support. A 60-year-old male presented with dyspnoea and a dry cough. Following extensive investigations, a radiological and histologic diagnosis of malignant solitary fibrous tumour of the pleura was made. This 4.3 kg tumour occupied the entire left hemithorax, involved the left lung and infiltrated into the pericardial cavity. Although the postoperative course was uneventful with a 12-day length of stay, the patient opted not to undergo adjuvant radiotherapy to a single positive margin site and died 6 months later due to local recurrence.
Keywords: Malignant; Pleura; Tumour.