ISSN : 2146-3123
E-ISSN : 2146-3131

Solitary Fibrous Tumors of Chest: Another Look with the Oncologic Perspective
Mert Saynak1, Nirmal K. Veeramachaneni2, Jessica L. Hubbs3, Dilruba Okumuş1, Lawrence B. Marks4
1Department of Radiation Oncology, Trakya University School of Medicine, Edirne, Turkey
2Department of Cardiovascular Surgery, University of Kansas Medical Center, Kansas City, USA
3Department of Obstetrics and Gynecology, University of North Carolina, North Carolina, USA
4Department of Radiation Oncology, University of North Carolina, North Carolina, USA
DOI : 10.4274/balkanmedj.2017.0350
Pages : 188-199

Solitary fibrous tumors are mesenchymal lesions that arise at a variety of sites, most commonly the pleura. Thoracic forms are generally asymptomatic at the time of diagnosis, and the radiographic features are a well-circumscribed, peripheral mass that abuts the pleural surface, frequently attached by a pedicle.

Solitary fibrous tumors are mesenchymal lesions that arise at a variety of sites, most commonly the pleura. Most patients are asymptomatic at diagnosis, with lesions being detected incidentally. Nevertheless, some patients present due to symptoms from local tumor compression (eg. of the airways and pulmonary parenchyma). Furthermore, radiological methods are not always conclusive in making a diagnosis, and thus, pathological analysis is often required. In the past three decades, immunohistochemical techniques have provided a gold standard in solitary fibrous tumor diagnosis. The signature marker of solitary fibrous tumor is the presence of the NAB2-STAT6 fusion that can be reliably detected with a STAT6 antibody. While solitary fibrous tumors are most often benign, they can be malignant in 10-20% of the cases. Unfortunately, histological parameters are not always predictive of benign vs malignant solitary fibrous tumors. As solitary fibrous tumors are generally regarded as relatively chemoresistant tumors; treatment is often limited to localized treatment modalities. The optimal treatment of solitary fibrous tumors appears to be complete surgical resection for both primary and local recurrent disease. However, in cases of suboptimal resection, large disease burden, or advanced recurrence, a multidisciplinary approach may be preferable. Specifically, radiotherapy for inoperable local disease can provide palliation/shrinkage. Given their sometimes -unpredictable and often- protracted clinical course, long-term follow-up post-resection is recommended.

Keywords : Solitary fibrous tumor, hemangiopericytoma, sarcoma, radiotherapy, chemotherapy, molecular targeted therapies

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