Which imaging findings are characteristic of malignant solitary fibrous tumors (SFTs) of the pleura?

Updated: Dec 25, 2019
  • Author: Joseph F Tomashefski, Jr, MD; more...
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Answer

Answer

The features of SFT seen on chest radiographs are most commonly those of a sharply circumscribed pleural-based soft-tissue mass. An obtuse angle is present at the intersection with the chest wall, suggesting an extrapulmonary location. The presence of pleural effusion may obscure the associated mass. Calcification is seen in less than 10% of cases. Large tumors may nearly fill the thoracic cavity and require CT scanning to define the site of origin.

On CT scans, most SFTs are heterogeneous, without invasion into adjacent structures. A pedicle at the point of attachment is sometimes seen. [8] Compared to benign SFTs, malignant SFTs tend to be larger, have a higher incidence of intratumoral low-attenuation areas, and exhibit pleural metastases on CT imaging, [47]  as well as having a casting mould-like growth, a rich blood supply, pleural effusions, and "geographic"-patterned enhancement. [48]


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