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Solitary fibrous tumor of the pleura presenting with syncope episodes when coughing

DOI: 10.1186/1477-7819-6-86

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We herein describe a case of 72 year-old man with head, facial, and thoracic traumas caused by neurally-mediated situational syncope when coughing. The diagnostic work-up including chest x-ray, CT and PET, revealed a large solitary mass of the left hemithorax. Radical surgical resection of the mass was performed through a left lateral thoracotomy and completed with a wedge resection of the lingula. Hystological examination of the surgical specimen showed an encapsulated mass measuring 12 × 11.5 × 6 cm consistent with a solitary fibrous tumor of the pleura. It's surgical removal definitively resolved the neurologic manifestations. The patient had no postoperative complications. At two years follow-up the patient is free from recurrence and without clinical manifestations.In our case its resection definitively resolved the episodes of situational syncope due, in our opinion, to the large thoracic mass compressing the phrenic nerveFirst described by Klemperer and Rabin [1], the solitary fibrous tumor of the pleura (SFTP) is a localized benign neoplasm arising from the submesothelial mesenchymal layer [2] even if malignant forms have also been described [3]. With about 800 cases reported in the world literature, this rare entity contrast with the primary diffuse pleural mesothelioma that have an incidence of 3000 new cases every year in the USA [4]. In over half of patients the tumor is asymptomatic, but if symptoms occur then chest pain, cough and dyspnea are the most common complaints. Complete en bloc surgical resection is the treatment of choice for these neoplasms offering a cure in all patients with benign form even if tumor recurrence may occur also in tumors with benign histological features [4,5]. We describe an unreported case of SFTP, to our knowledge, manifesting with syncope episodes when coughing.A 72 year-old man was admitted to the hospital for head injury, facial and left hemithorax contusions. The patient referred to had fainted after coughing; the sam

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