Abstract English: Solitary fibrous tumours (SFTs) are rare mesenchymal neoplasms with an incidence of less than one case per million people per year, most often exhibiting benign behaviour. Their intrapulmonary localisation is exceptionally uncommon and illustrates the hetero-geneity of pulmonary tumours in both clinical presentation and histopathology. We report the case of a 76-year-old female, aformer smoker (10 pack-years, quit 20 years ago), with advanced cardiometabolic comorbidities. A recent chest computed tomography (CT) scan revealed a large, well-defined pulmonary mass (85 × 64 mm) in the lingular segment of the left upper lobe, associated with condensating-atelectatic changes and ground-glass opacities in the right lower lobe, suggestive of infection and minimal right pleural effusion. Empirical antibiotic therapy was initiated, and the patient was referred to the pulmonology department. Bronchoscopy excluded endobronchial invasion, and CT-guided transthoracic biopsy confirmed SFTs based on morphology and immunohistochemical profile signal transducer and activator of transcription 6, cluster of differentiation 34, pan-cytokeratin AE1/AE3 and SRY-related HMG-box 10 (STAT6+, CD34+, CK-AE1/3- and SOX10-). Risk assessment using the modified Demicco score indicated a low metastatic potential. Given the patient’s age, comorbidities and low-risk profile, a ‘watchful waiting’ strategy with periodic clinical and imaging follow-up was adopted in agreement with the thoracic surgery team. This case highlights the complexity of SFTs regarding localisation and therapeutic management, emphasising the essential role of a rigorous multidisciplinary approach, particularly in the absence of validated treatment guidelines derived from large patient cohorts.
Brișan et al. (Wed,) studied this question.