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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 5, Issue.: 10


A Simple Computed Tomography Scoring System to Predict Histological Malignancy of Solitary Fibrous Tumors of the Pleura


Siegfried Hélage1*, Marie-Pierre Revel1, Marco Alifano2, Audrey Mansuet-Lupo3 and Dominique Vadrot1

1Department of Radiology, Hôpital Hôtel-Dieu de Paris (AP-HP), 1 Place du Parvis Notre-Dame, 75004 Paris, France.
2Department of Thoracic Surgery, Hôpital Hôtel-Dieu de Paris (AP-HP), 1 Place du Parvis Notre-Dame, 75004 Paris, France.
3Department of Pathological Anatomy and Cytology, Hôpital Hôtel-Dieu de Paris (AP-HP), 1 Place du Parvis Notre-Dame, 75004 Paris, France.

Article Information
(1) Chulso Moon, The JS YOON Memorial Cancer Research Institute, USA and Department of Otolaryngology and Head and Neck Cancer, Research Institute, The Johns Hopkins University School of Medicine, Baltimore, USA.
(1) Anonymous, University of Sao Paulo Medical School, Sao Paulo, Brazil.
(2) Anonymous, University of Medical Science, Japan.
Complete Peer review History: http://www.sciencedomain.org/review-history/6795


Purpose: The aim of the present study was to define the very first score enabling discrimination between benign and malignant solitary fibrous tumors of the pleura (SFTPs), on the basis of reliable preoperative CT features.
Methods: Between December 2004 and November 2012, 56 patients underwent complete resection for SFTP at six institutes. CT scans were reviewed retrospectively, and a diagnostic scoring system for predicting malignant SFTP preoperatively was designed.
Results: Univariate analysis revealed seven significant predictors of malignant SFTP: tumor size ≥ 10 cm (p=0.002), tumor heterogeneity spontaneously (p=0.019) or after contrast medium injection (p=0.029), existence of intratumoral fluid density areas (p=0.011), a pleural effusion (p=0.01), measurable (diameter >1 mm) intratumoral vessels (p=0.019), a hypervascular character (visible intratumoral vessels and/or intense enhancement) (p=0.001). A scoring system based on these seven CT features, each assigned 1 point, and with a cut-off of 4 points, could predict malignant SFTP with a specificity of 85% and a sensitivity of 48%.
Conclusion: Our scoring system using seven CT features (tumor size ≥ 10 cm, tumor heterogeneity with or without contrast injection, intratumoral fluid density areas, pleural effusion, measurable intratumoral vessels, and a hypervascular character of the tumor) may be helpful for predicting histological malignancy of solitary fibrous tumors of the pleura.

Keywords :

Solitary fibrous tumor; SFT; Pleura; pleural fibroma; CT scan; scoring system.

Full Article - PDF    Page 1301-1308

DOI : 10.9734/BJMMR/2015/13958

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