CTICasesMalignant Solitary Fibrous Tumor of Pleura with Metastatic Papillary Thyroid Carcinoma
Imaging findings
Chest radiography demonstrates a very large, solid, heterogeneous mass in the right hemithorax with some areas of low attenuation, internal vascularity, and calcification, alongside subcarinal lymphadenopathy. FDG-PET reveals minimal metabolic activity within the pleural mass and subcarinal nodes, but unexpectedly demonstrates two highly FDG-avid thyroid nodules and an avid regional cervical lymph node.
Key takeaways
Histopathology of the large pleural mass confirmed a malignant solitary fibrous tumor of the pleura, which stained positive for STAT6. Surprisingly, the specimen also harbored metastatic papillary thyroid carcinoma, representing the simultaneous diagnosis of two distinct, unrelated oncological processes mimicking a single aggressive disease or widespread metastasis. STAT6 is a highly sensitive and specific immunohistochemical marker for solitary fibrous tumors.
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