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Thorac Cardiovasc Surg 2008; 56(5): 291-297
DOI: 10.1055/s-2007-965767
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Solitary Fibrous Tumors of the Pleura: Clinicopathological Characteristics, Immunohistochemical Profiles, and Surgical Outcomes with Long-Term Follow-Up

C.-C. Liu1 , H.-W. Wang1 , F.-Y. Li2 , P.-K. Hsu1 , M.-H. Huang1 , W.-H. Hsu1 , H.-S. Hsu1 , L.-S. Wang3
  • 1Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
  • 2Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
  • 3Institute of Emergency and Critical Care Medicine, National Yang-Ming University, En Chu Kong General Hospital, Taiwan
Further Information

Publication History

received July 28, 2007

Publication Date:
09 July 2008 (online)

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Abstract

Background: Solitary fibrous tumors of the pleura (SFTP) are rare. The aims of this study were (1) to characterize their clinicopathological features more precisely; (2) to determine whether an immunohistochemical (IHC) study can be helpful in distinguishing benign from malignant SFTPs; and (3) to provide more complete information to better predict prognosis. Methods: Microscopic examinations of tumorous specimens from 15 patients were repeated and the tumors were reclassified. In addition to evaluating clinicopathological variables, expressions of p16, p53, Ki-67, CD-117, estrogen receptor (ER), and progesterone receptor (PR) biomarkers were studied and their clinicopathological and prognostic significance analyzed. Results: Of the 15 enrolled patients (mean age 57 years; 8 men and 7 women), 8 were symptomatic when diagnosed. Eight patients underwent CT-guided needle biopsies before surgery and two had positive findings. All cytologic studies of pleural effusion were negative for malignant cells. Complete pleural resection with adequate safe margins was performed for all patients. Eleven cases proved to have benign tumors and 4 had malignancies. Local recurrence occurred in 3 cases and distant metastasis in one. Conventional factors, including tumor size, tumor shape, symptomatic presentation, and histological type did not affect prognosis. Interestingly, p16 expression was significantly associated with tumor recurrence (p = 0.009). Conclusion: Complete pleural resection with adequate safe margins can achieve satisfactory outcomes in a majority of cases, but long-term follow-up for all patients is recommended due to the potential for late tumor recurrence. Conventional clinicopathological variables do not affect prognosis. However, IHC studies of the CD-34 and bcl-2 biomarkers can be important for further differential diagnosis, and p16 expression can be used to predict tumor recurrence.

Key words

solitary fibrous tumor of the pleura - immunohistochemical study - p16

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MD, Professor of Surgery Liang-Shun Wang

Institute of Emergency and Critical Care Medicine
National Yang-Ming University
En Chu Kong General Hospital

No. 201, Sec. 2, Shih-Pai Road

Taipei 112

Taiwan

Phone: + 886 (2) 28 75 75 46

Fax: + 886 (2) 28 73 14 88

Email: lswang@vghtpe.gov.tw