Author of

• 18670

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  P3.04 - Poster Session with Presenters Present (ID 474)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18711

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    P3.04-041 - Giant Solitary Fibrous Tumor of the Pleura Saved by Biopsy and Following Extended Resection: A Long Term Surviving Case (ID 5270)

    14:30 - 14:30  |  Author(s): X. Qiu
    • Abstract

    Background:
    Giant tumor almost occupied the entire one-side thoracic cavity could be surgically resected completely is rare. Solitary fibrous tumor of the pleura (SFTP) is less common, giant SFTP, which could be surgically resected completely, could survive long term, is rare. Here we report one case giant SFTP.
    
    Methods:
    A male aged 39 in Dec 2008, with chest distress, fatigue and low-grade fever for 2 weeks, chest pain and dyspnea for 1 week, no bleeding sputum; chest CT revealed a giant tumor almost occupied the entire left-side thoracic cavity, with pleural effusion. Bloody pleural fluid was drawn but no malignant tumor cells was confirmed. Malignant mesothelioma was diagnosed at local hospital, not operable, no effective chemotherapy or radiation available. The patient was referred to our Lung Cancer Center. Biopsy was first advised. Biopsy pathology: SFTP (malignant). Surgical resection should be of the best choice even though the young patient seemed to be too fatigue to endure the large-incision traditional standard posterolateral thoracotomy (TSPT, 30~40cm long chest incision, with the latissimus dorsi and serratus anterior muscles being cut, usually one rib being cut).
    
    Results:
    Posterolateral incision was about 40cm long, S shape, with one rib cut, but the surgery space was still too limited to explore the giant tumor, to separate the intrathoracic adhesion. Incision was extended, and another rib was cut to enlarge the surgical field. The tumor occupied the whole thoracic cavity, bottom originated from visceral pleura of left apicalposterior (S1+2) and superior (S6) segments. Tumor 22cm×15cm×7cm was completely separated and en bloc resected, with S1+2 and S6 segments wedge-resected (cutting edges at least 2cm far from tumor). Postoperative pathology: SFTP (malignant). The patient recovered surprisingly quickly, drainage tube pulled out at 5[th] day, he was discharged at the 8[th] day postoperatively. No adjuvant treatment was used. Follow-up shows no recurrence and metastasis. The patient is now alive healthily in his 8th year postoperatively,
    
    Conclusion:
    Giant SFTP is rare, easily to be misdiagnosed to malignant mesothelioma, losing opportunity of being cured. Biopsy is the key point to make a right diagnosis. Giant SFTP, benign or malignant, usually is operable; complete en bloc resection of the whole tumor and enough resection of originated visceral pleura and lung tissue is the key point to avoid recurrence, to cure SFTP. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05).