Solitary fibrous malignant tumor of the pleura with associated hypoglycemia: a case report

Background. Solitary fibrous tumor (sFT) is a rare mesenchimal neoplasm of fibroblastic origin. There is no generally accepted classification for sFT. Surgery is the main treatment modality. Disease recurrence occurs in 2-14 % of patients. Re-surgery is recommended to treat recurrence because alternative treatment options are ineffective. Persistent hypoglycemia is observed in less than 5 % of patients, and values return to normal 24 days after tumor removal.

Case description. A 53-year-old woman was admitted to the Thoracic Department of PA. Gertsen Moscow Research Institute of Oncology with consciousness disorder at the level of spoor. The severity of the disease was caused by the syndrome of compression and displacement of the mediastinal structures to the left and respiratory failure: anemia, glycemia 1.2 pmol/ml. Immunohistochemical examination revealed solitary fibrous tumor with evidence of malignancy. In the preoperative period, to maintain the glycemia level within the normal range, continuous infusion of 10 % glucose solution was administered. The total infusion volume was 10 liters per day. Tumor in the right hemithorax was removed and atypical resection of the middle and lower lobes of the right lung was performed. In the postoperative period, glucose levels were in normal limits and additional treatment was not required.

Conclusion. SFT is a rare neoplasm of mesenchymal origin. The lack of clear diagnostic criteria and diagnostic standards for the description of individual cases remains relevant. Clinical manifestations of disease occur mainly in cases with large tumors. Early timely surgical excision of the tumor in case of suspicion of a solitary fibroid tumor is recommended, since over time, benign neoplasm may acquire a malignant behavior and metastasize.

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