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Cancer Control : Journal of the Moffitt... Oct 2006The solitary fibrous tumor of the pleura (SFTP) is a rare primary tumor arising from mesenchymal cells in the areolar tissue subjacent to the mesothelial-lined pleura.... (Review)
Review
BACKGROUND
The solitary fibrous tumor of the pleura (SFTP) is a rare primary tumor arising from mesenchymal cells in the areolar tissue subjacent to the mesothelial-lined pleura. Only about 800 cases have been reported in the medical literature. The tumor appears to be unrelated to malignant pleural mesothelioma, the most common primary tumor of the pleura.
METHODS
In just over half of these cases, the neoplasm presents as an asymptomatic mass, is often quite large, and is benign in 78% to 88% of patients. The initial evaluation and diagnosis, tumor classification, surgical treatment, results of therapy, and long-term prognosis are reviewed, based on a selective review of the literature from MEDLINE beginning 1980.
RESULTS
Complete en bloc surgical resection is the preferred treatment of benign and malignant varieties of the tumor. The pedunculated tumors attached to the visceral pleura can be effectively treated with a wedge resection of lung. Sessile tumors arising on the lung require a larger lung resection. Sessile tumors on the chest wall require wide local excision, often with chest wall resection because of their propensity for local recurrence. Adjuvant therapy remains controversial in SFTP.
CONCLUSIONS
Benign SFTP has a high cure rate and an 8% local recurrence rate that is usually amenable to curative re-excision. Malignant SFTP, especially the more common sessile type, has a 63% recurrence rate even with complete resection. The majority of patients with recurrent disease die of the tumor within 2 years. Nevertheless, the overall long-term cure rate for all patients is 88% to 92%.
Topics: Diagnosis, Differential; Humans; Incidence; Neoadjuvant Therapy; Neoplasms, Fibrous Tissue; Pleural Neoplasms; Thoracic Surgical Procedures; Tomography, X-Ray Computed; United States
PubMed: 17075563
DOI: 10.1177/107327480601300403 -
Ultrastructural Pathology Dec 2011Primary pleural epithelioid mesothelioma with clear cell morphology is a particularly rare neoplasm, with only a few documented cases. Here, the authors report a case of... (Review)
Review
Primary pleural epithelioid mesothelioma with clear cell morphology is a particularly rare neoplasm, with only a few documented cases. Here, the authors report a case of a 76-year-old man, with a history of asbestos exposure, admitted for mild dyspnea. Radiologic examination revealed right pleural effusion and pleural thickening. Cytological examination of aspirated pleural samples was consistent with non-small cell carcinoma. Histological examination of the resected, via VATS, plural specimens was consistent with the diagnosis of clear cell epithelioid mesothelioma. The authors further analyze the main morphological and immunohistochemical features of clear cell epithelioid mesothelioma, emphasizing the algorithm for excluding other clear cell tumors metastatic to the pleura.
Topics: Aged; Asbestos; Biomarkers, Tumor; Biopsy; Diagnosis, Differential; Dyspnea; Epithelioid Cells; Humans; Immunohistochemistry; Male; Mesothelioma; Pleural Effusion, Malignant; Pleural Neoplasms; Predictive Value of Tests; Thoracic Surgery, Video-Assisted
PubMed: 21978187
DOI: 10.3109/01913123.2011.606965 -
Interactive Cardiovascular and Thoracic... Apr 2020A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In lung cancer patients with unexpected pleural... (Review)
Review
Is surgical resection of primary tumour superior to exploratory thoracotomy without resection in treating lung cancer patients with unexpected pleural metastasis detected during operation?
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In lung cancer patients with unexpected pleural metastasis detected during operation, is surgical resection of primary tumour superior to exploratory thoracotomy without resection in improving long-term survival?'. Altogether, 1443 papers were found using the reported search, of which 1 meta-analysis and 10 retrospective observational cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. One meta-analysis and 9 cohort studies found that surgical resection of the primary tumour, on the discovery of pleural metastases, yielded a better overall survival than exploratory thoracotomy alone, while 1 cohort study showed no difference. Six studies found that main tumour resection was an independent favourable prognostic factor for overall survival in lung cancer patients with unexpected pleural metastasis detected during operation, while 3 cohort studies also showed improved progression-free survival over exploratory thoracotomy. Therefore, we conclude that surgical resection of the primary tumour is superior to exploratory thoracotomy in treating lung cancer patients with unexpected pleural metastasis detected during operation.
Topics: Aged; Humans; Intraoperative Period; Lung Neoplasms; Male; Neoplasm Metastasis; Neoplasm Staging; Pleural Neoplasms; Pneumonectomy; Retrospective Studies; Thoracotomy; Treatment Outcome
PubMed: 31965162
DOI: 10.1093/icvts/ivz315 -
Current Opinion in Pulmonary Medicine Jul 2008Malignant mesothelioma is a uniformly fatal disease and active supportive care, minimizing patient morbidity, remains the accepted standard treatment. Tract metastases... (Review)
Review
PURPOSE OF REVIEW
Malignant mesothelioma is a uniformly fatal disease and active supportive care, minimizing patient morbidity, remains the accepted standard treatment. Tract metastases in patients with mesothelioma are a well recognized complication of pleural intervention and prophylactic radiotherapy is commonly implemented to prevent their occurrence. This review critically analyzes the published literature to establish the role of prophylactic radiotherapy to pleural puncture sites and highlights controversies that exist.
RECENT FINDINGS
Current practice is based on a clinical study published in 1995. However, two recent randomized controlled trials did not support the widely held belief that all patients undergoing diagnostic or therapeutic pleural puncture should receive prophylactic drain site irradiation. Data assessing the incidence of associated morbidity from tract metastases suggest that rates are lower than previously thought.
SUMMARY
The routine administration of radiotherapy in all patients with mesothelioma following pleural intervention remains debated. Instead of prophylactic irradiation, directing surveillance toward patients with large (e.g. thoracoscopic) pleural puncture sites and reserving treatments to symptomatic deposits may be more appropriate. This strategy would optimize patient care and minimize hospital visits, but allow prompt instigation of treatment if symptoms develop.
Topics: Humans; Incidence; Mesothelioma; Neoplasm Metastasis; Neoplasm Seeding; Neoplastic Cells, Circulating; Pleural Neoplasms; Punctures; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 18520267
DOI: 10.1097/MCP.0b013e3282fcea50 -
Journal of Thoracic Oncology : Official... Nov 2008We aimed to examine the frequency of pleural adhesions and to determine their relationship with pleural tumor burden, pleural fluid (PF) biochemistries, PF cytologic...
BACKGROUND AND OBJECTIVE
We aimed to examine the frequency of pleural adhesions and to determine their relationship with pleural tumor burden, pleural fluid (PF) biochemistries, PF cytologic yield, and survival in patients with malignant pleural effusion (MPE).
METHODS
We performed retrospective analysis of 540 consecutive patients with MPE who underwent medical thoracoscopy. Pleural lesion rating and grade of pleural adhesions based on a thoracoscopic score model were recorded.
RESULTS
Sixty percent of patients with MPE were found to have adhesions in the pleural space. The sensitivity of PF cytology was 71% if there were no pleural adhesions, and 20% if the maximum adhesion score was reached (p < 0.01). The extent of pleural adhesions correlated positively with the pleural tumor burden, and inversely with PF pH. The median survival of patients with minimal or no adhesions in the pleural space was 9 months as compared with patients with the highest grade of adhesions, whose median survival was 5 months (p < 0.01).
CONCLUSION
MPE are often loculated. The higher the grade of pleural adhesions, the greater the tumor burden exists, and paradoxically the lower the PF cytologic yield. The presence of pleural adhesions in MPE implies a poor prognosis.
Topics: Female; Humans; Hydrogen-Ion Concentration; Lactate Dehydrogenases; Male; Middle Aged; Neoplasm Staging; Pleural Diseases; Pleural Effusion, Malignant; Pleural Neoplasms; Prognosis; Prospective Studies; Retrospective Studies; Survival Rate; Thoracoscopy; Tissue Adhesions
PubMed: 18978559
DOI: 10.1097/JTO.0b013e318189f53d -
Nederlands Tijdschrift Voor Geneeskunde Sep 1968
Topics: Neoplasm Metastasis; Pleural Effusion; Pleural Neoplasms
PubMed: 5680136
DOI: No ID Found -
Bulletin Du Cancer Nov 2005Asbestos is known as mutagenic and carcinogenic for human and is responsible for many pulmonary diseases including asbestosis, bronchogenic carcinoma and malignant... (Review)
Review
Asbestos is known as mutagenic and carcinogenic for human and is responsible for many pulmonary diseases including asbestosis, bronchogenic carcinoma and malignant pleural mesothelioma. Occupational exposure to asbestos is involved in 70-80% of all malignant pleural mesothelioma. The later presents a growing challenge for both researcher and clinician. The diagnosis of malignant pleural mesothelioma is difficult and the current treatments did not show significant improvement of the survival. The increasing incidence of malignant pleural mesothelioma, its gravity and its human, social and financial consequences are of high concern in public health. In this paper we summarize the so far knowledge on cellular, molecular and pathophysiological events involved in genesis and development of malignant pleural mesothelioma. Finally, the paper also report recent data sourced from the study of malignant pleural mesothelioma transcriptome using high-throughput technologies such as gene expression array. These data should improve the accuracy of mesothelioma diagnosis and therapy.
Topics: Asbestos; Cell Division; Cell Transformation, Neoplastic; Chromosome Aberrations; Combined Modality Therapy; DNA Damage; Gene Expression Regulation, Neoplastic; Humans; Incidence; Inhalation Exposure; Mesothelioma; Mineral Fibers; Occupational Diseases; Pleural Neoplasms; Prognosis; RNA, Messenger; RNA, Neoplasm; Transcription, Genetic
PubMed: 16316830
DOI: No ID Found -
Nihon Rinsho. Japanese Journal of... Jan 1993
Topics: Adolescent; Adult; Age Factors; Aged; Cytodiagnosis; Female; Humans; Japan; Male; Mesothelioma; Middle Aged; Neoplasm Staging; Pleural Neoplasms; Sex Factors; Survival Rate; Tomography, X-Ray Computed
PubMed: 8459605
DOI: No ID Found -
Future Oncology (London, England) 2015Recurrence after surgery in the multimodality therapy for malignant pleural mesothelioma is a common problem. As the majority of patients experience not only local but... (Review)
Review
Recurrence after surgery in the multimodality therapy for malignant pleural mesothelioma is a common problem. As the majority of patients experience not only local but also distant metastases, a systemic treatment strategy in addition to local control measures remains necessary. Nevertheless, none of the chemotherapy regimens have achieved clinical success. Local management modalities such as stereotaxic treatments, cryoablation and redo surgery on the other hand have promising results, but provide palliative outcomes.
Topics: Combined Modality Therapy; Disease Management; Humans; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Neoplasm Recurrence, Local; Pleural Neoplasms
PubMed: 26638919
DOI: 10.2217/fon.15.312 -
Pathology, Research and Practice Feb 2017Melanoma in children, adolescents, and young adults is uncommon and reported almost exclusively as cutaneous melanoma. Melanoma presenting as a pleural effusion is very...
Melanoma in children, adolescents, and young adults is uncommon and reported almost exclusively as cutaneous melanoma. Melanoma presenting as a pleural effusion is very rare in adults and not reported in the pediatric population. Additionally, primary pulmonary melanoma is overall very rare and undocumented in pediatric patients. Furthermore, the distinction between a primary pulmonary/pleural melanoma versus a regressed cutaneous melanoma with pulmonary/pleural metastases remains extremely challenging. We discuss a case of a previously healthy 13-year-old girl that presented with a left-sided pleural effusion. Investigations revealed a large mediastinal mass, left-sided pleural and pulmonary nodules, a sacral mass, and bone marrow infiltration. The neoplasm was subsequently diagnosed by morphology and immunocytochemistry with histological correlation as malignant melanoma. As no mucosal, eye, or cutaneous lesions were identified, we deliberate the likelihood of a regressed cutaneous melanoma with metastases versus primary pulmonary/pleural melanoma with pleural effusion and discuss its diagnostic approach.
Topics: Adolescent; Fatal Outcome; Female; Humans; Lung Neoplasms; Melanoma; Pleural Effusion, Malignant; Pleural Neoplasms
PubMed: 27894618
DOI: 10.1016/j.prp.2016.11.013