Tuberc Respir Dis.  2009 Nov;67(5):449-453.

Intrathoracic Desmoid Tumor Mimicking Pleural Mass: A Case Report

• Kim NR
• Chung DH
• Lee JI
• Jeong SH
• Ha SY

Abstract

Desmoid tumor (fibromatosis) is a histologically benign fibrous neoplasm showing locally infiltrating growth. This type of tumor commonly occurs in the abdomen, but intrathoracic desmoid tumor is uncommon. To date, 12 cases of intrathoracic desmoid tumor protruding into the pleural cavity, radiologically mimicking pleural masses, have been reported. Here, we report on a case of intrathoracic desmoid tumor protruding into the pleural cavity, and partially covered by parietal pleura. The main preoperative differential diagnoses included pleural solitary fibrous tumor, inflammatory pseudotumor or malignant mesothelioma. A near-total mass excision was performed. Pathologically, the tumor was composed of a paucicellular arrangement of spindle-shaped cells with fibromyxoid stroma. The resection margin was partially involved with spindle cells present. On histochemical staining, the spindle cells were strongly positive for vimentin and negative for CD34, consistent with a desmoid tumor. The patient was stable without further adjuvant treatment during 6-years of follow-up.

Keyword

Fibromatosis, Abdominal; Pleura

MeSH Terms

Abdomen
Diagnosis, Differential
Fibromatosis, Abdominal
Fibromatosis, Aggressive
Follow-Up Studies
Granuloma, Plasma Cell
Humans
Mesothelioma
Pleura
Pleural Cavity
Solitary Fibrous Tumors
Vimentin
Vimentin

Figure

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  Figure 1 A chest CT scan reveals a low density thoracic wall mass (arrows) protruding into the pleural cavity.

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  Figure 2 (A) Hypocellular spindle cells have small indistinct nucleoli and weakly eosinophilic cytoplasm in the fibromyxoid background (H&E stain, ×200). (B) Spindle cells are stained with vimentin (vimentin immunostain, ×400).

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