Persistent chronic cough is a common outpatient symptom, typically caused by gastroesophageal reflux, asthma, or upper airway cough syndrome. Rare causes, including metastatic tumors, may present with nonspecific respiratory symptoms, particularly in patients with a history of malignancy. A 59-year-old man with a prior left frontal grade II solitary fibrous tumor (SFT) resected in 2012 presented with a 2-3-month history of dry cough. Initial empiric therapy for gastroesophageal reflux and post-nasal drip failed. Chest radiograph revealed multiple bilateral pulmonary nodules, and CT chest showed an 8 × 4.5 cm subcarinal mass. Bronchoscopy with transbronchial needle aspiration confirmed metastatic pulmonary SFT. The patient is now being followed by oncology for staging and treatment planning. Persistent cough that does not improve with empiric therapy warrants early imaging, especially in patients with prior malignancy. This case highlights that SFT can metastasize many years after initial treatment, presenting with common symptoms such as cough. Timely reassessment can prevent delays in diagnosis and management.
Liu et al. (Mon,) studied this question.