Solitary Fibrous Tumour of the Pleura Presenting as a Spontaneous Massive Haemothorax

Solitary fibrous tumours of the pleura are rare neoplasms. These tumours are generally asymptomatic and incidentally diagnosed. Symptoms, if present, are nonspecific such as cough, dyspnea, and chest pain. This report describes the case of a 38-year-old woman admitted to our department after the onset of a right massive spontaneous haemothorax requiring emergency surgical treatment. Intraoperatively a bleeding pleural mass was found to be the cause of the haemothorax. The tumour was successfully resected and the patient made an uneventful recovery. Histological examination revealed the mass to be a solitary fibrous tumour of the pleura. 1. Introduction Solitary fibrous tumours of the pleura (SFTP) are rare tumours of mesenchymal origin. SFTP may arise from the visceral or the parietal pleura and may present as small nodules or large masses. For the most part, SFTP are chance findings as they are usually asymptomatic. Symptoms, when present, are generally due to a mass effect and compression and are the same as those observed with other intrathoracic masses, namely, cough, thoracic pain, and dyspnea. Other symptoms, such as haemoptysis, and paraneoplastic syndromes and most commonly a refractory hypoglycemia have been reported [1–4]. In a few cases serous pleural effusion may also be associated with SFTP. To the best of our knowledge, SFTP presenting as a spontaneous haemothorax has been very rarely described in the literature [5–7]. This report describes the case of a 38-year-old woman admitted to our Department of Thoracic Surgery for a right massive spontaneous haemothorax. Emergency surgical thoracotomy revealed a bleeding mass arising from the parietal pleura to be the cause of the haemorrhage. Resection of the mass halted the bleeding and subsequent pathological evaluation revealed it to be a benign SFTP. 2. Case Report A 38-year-old woman was referred to our Department of Thoracic Surgery for a right massive spontaneous haemothorax. She was initially assessed by the Emergency Department of another hospital where she complained of acute right chest pain and dyspnea. A chest radiograph performed on initial evaluation revealed a right pleural effusion. Computed tomography of the chest indicated the nature of the pleural effusion to be consistent with a haemothorax. A parietal paravertebral opacity, suspected to be an intrathoracic tumour surrounded by blood clots, was detected (Figure 1). The patient was urgently transferred to our department for surgical evaluation. The clinical status of the patient rapidly worsened with hypotension and