Journal name: World Journal of Pharmaceutical Research
Original article title: Solitary fibrous tumour of the pleura
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: surgical treatment, our cases analyse.
Original source:
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Fadil Gradica, Dhimitraq Argjiri, Lutfi Lisha, Fahri Kokici, Alma Cami and Edlira Ndreu
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Solitary fibrous tumour of the pleura
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr201610-7067
Download the PDF file of the original publication
Summary of article contents:
Introduction
Solitary fibrous tumors (SFT) of the pleura are infrequent neoplasms derived from mesenchymal tissue, situated beneath the mesothelial layer of the pleura. These tumors are characterized by their unpredictable clinical behavior, exhibiting a range of histological and morphological features. The objective of the study conducted at the University Hospital "Shefqet Ndroqi" in Tirana, Albania, was to assess surgical treatment outcomes for patients diagnosed with SFTs of the pleura over a 15-year period, from September 1999 to April 2014.
Surgical Treatment Outcomes
The study encompassed 21 patients who underwent surgical resection for SFTs of the pleura, with noteworthy findings regarding the surgical approach and patient outcomes. Surgical interventions included 19 posterolateral thoracotomies, seven anterio-lateral thoracotomies, and one video-assisted thoracoscopy. The average tumor diameter was recorded at 8.5 cm, with complete resections achieved for all patients. Remarkably, there were no intraoperative or perioperative complications reported, and the median duration for chest drainage and hospital stay were respectively 3 days and 5 days. Only one case of tumor recurrence was noted during a median follow-up period of 70 months.
Clinical Presentations and Diagnosis
The clinical presentation of SFTs varied among patients. Of the total cases, 43% were asymptomatic, while the other 57% reported symptoms including dyspnea, cough, chest pain, and hypoglycemia—a symptom linked to insulin-like growth factor secretion from the tumor. Histopathological analysis included immunohistochemical tests that highlighted the tumors' mesenchymal origin, with positive CD34 antigen staining. Diagnosis was typically confirmed through biopsy, revealing that out of the patients studied, 16 had benign tumors while 11 were classified as malignant.
Histopathological Features
Comparative analysis of the histopathologic characteristics between the benign and malignant groups revealed significant differences. Increased cellularity and pleomorphic features were much more prevalent in malignant cases. Specifically, 72% of malignant tumors exhibited increased cellularity, and 82% showed pleomorphism, compared to only 12.6% and 6.3% of benign tumors, respectively. While gross features showed minimal differences across groups, these microscopic distinctions are crucial for prognosis and treatment decisions.
Conclusion
In conclusion, surgical resection of benign solitary fibrous tumors of the pleura is generally deemed curative, although local recurrences can occur years later, highlighting the importance of long-term follow-up. Conversely, malignant solitary fibrous tumors typically present a poor prognosis, indicating a greater risk of recurrence and disease progression. Clinical and radiological monitoring remains essential for both benign and malignant tumors to ensure timely intervention and comprehensive patient care.
FAQ section (important questions/answers):
What are solitary fibrous tumors of the pleura?
Solitary fibrous tumors (SFT) of the pleura are rare tumors arising from mesenchymal tissue beneath the mesothelial layer. They have an unpredictable clinical course, which may vary based on their histological and morphological characteristics.
What was the aim of the study on SFTs?
The study aimed to evaluate the experience and outcomes of surgical treatment for solitary fibrous tumors of the pleura, including patient details, surgical approaches, and pathological features.
What were the common symptoms of SFTs in patients?
Among patients, common symptoms included dyspnea, coughing, chest pain, finger clubbing, and hypoglycemia. Notably, 43% of patients were asymptomatic at diagnosis.
How were solitary fibrous tumors of the pleura diagnosed?
Diagnosis typically involved imaging studies like chest X-rays and CT scans, combined with biopsy via Fine Needle Aspiration or VATS, ensuring accurate identification of the tumor type.
What are the surgical outcomes for SFT patients?
All surgeries resulted in complete tumor resections, with no operative complications. The median hospital stay was 5 days, and only one patient experienced tumor recurrence during follow-up.
What is the prognosis for benign and malignant SFTs?
Benign solitary fibrous tumors generally have a good prognosis post-surgery, while malignant tumors have a poorer prognosis, with a significant risk of local recurrence and disease progression.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Solitary fibrous tumour of the pleura”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Study (Studying):
The term 'Study' refers to the systematic investigation conducted by the authors to evaluate their experience in the surgical treatment of solitary fibrous tumors of the pleura. It encompasses clinical features, patient outcomes, and histopathological evaluations that contribute to the understanding and management of this rare tumor type.
2) Table:
The word 'Table' denotes the organized presentation of data within the manuscript, summarizing the clinical features and pathological characteristics of benign and malignant solitary fibrous tumors. Tables are critical for reader comprehension, providing a clear visual representation of findings, comparisons, and statistical analyses that facilitate interpretation.
3) Pain:
In the text, 'Pain' signifies a common clinical symptom among patients with solitary fibrous tumors. It highlights the overall discomfort experienced by individuals, impacting their quality of life. Understanding pain as a clinical feature assists healthcare providers in recognizing the severity of the tumor's impact on patients' well-being.
4) Disease:
The term 'Disease' is employed to denote the pathological condition associated with solitary fibrous tumors of the pleura. Understanding the disease's characteristics, including its benign and malignant forms, is pivotal for effective diagnosis and treatment, allowing clinicians to implement appropriate therapeutic strategies tailored to each patient's needs.
5) Sign:
'Sign' refers to the observable indicators or symptoms presented by patients with solitary fibrous tumors. Recognizing these signs is crucial for clinicians to make timely diagnoses and initiate appropriate treatment protocols, ultimately contributing to better patient outcomes through early intervention and monitoring of the disease's progression.
6) Pur:
The word 'Poor' is used to describe the unfavorable prognosis associated with malignant solitary fibrous tumors. This term emphasizes the challenges faced by patients, as the likelihood of recurrence and disease progression is significantly higher. Understanding this aspect aids in guiding clinical decisions and counseling patients regarding their condition.
7) Chemotherapy:
'Chemotherapy' represents a potential treatment modality for malignant solitary fibrous tumors. Although the effectiveness of chemotherapy in this context is controversial, the mention of it highlights the multidisciplinary approach required for managing such tumors, which may involve collaboration with oncologic specialists to optimize patient outcomes.
8) Radiotherapy:
The term 'Radiotherapy' is included to denote another treatment option for patients with malignant solitary fibrous tumors. Like chemotherapy, its role in treatment is debated. The mention of radiotherapy underscores the importance of considering comprehensive treatment plans that may involve multiple modalities to address the complex nature of malignancies.
9) Performance:
'Performance' refers to the overall clinical outcomes and responses observed in patients following surgical interventions for solitary fibrous tumors. Monitoring performance metrics enables healthcare professionals to assess the effectiveness of treatment strategies and improve patient management protocols, leading to enhanced survival rates and quality of life.
10) Surrounding:
The word 'Surrounding' describes the anatomical and physiological context in which solitary fibrous tumors of the pleura develop. Understanding the surrounding structures and tissues is essential for surgical planning, as it helps identify potential complications and ensures complete tumor resection while preserving adjacent normal tissue integrity.
11) Discussion:
'Discussion' denotes a critical section of the manuscript where the authors analyze and interpret their findings in relation to existing literature. This provides valuable insights into the implications of their research on clinical practice, highlights areas for future study, and encourages an ongoing dialogue within the medical community regarding solitary fibrous tumors.
12) Fever:
'Fever' indicates an uncommon symptom among patients with solitary fibrous tumors, suggesting a possible inflammatory response or systemic involvement. Recognizing fever as a clinical sign assists clinicians in differentiating between benign and malignant presentations, facilitating timely interventions and appropriate management strategies for affected individuals.
13) Wall:
'Wall' refers to the anatomical structures like the chest wall or pleural surfaces that may be involved when considering solitary fibrous tumors. Understanding the relationship between the tumor and the wall is crucial for surgical approach, determining whether resection is feasible and how to minimize impact on surrounding structures.
14) Male:
'Male' signifies the gender distribution among patients in the study, with specific reference to the number of male versus female cases. This demographic detail is significant for understanding epidemiological trends in solitary fibrous tumors, informing clinicians about potential risks and tailoring awareness and screening protocols for different populations.