Thoracic Solitary Fibrous Tumors: Imaging Findings in Five Cases

Abstract

Introduction: Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms, most commonly arising from the pleura, with a broad spectrum of clinical behavior ranging from benign to aggressive malignant forms. Because of their rarity, variable presentation, and overlapping imaging features with other thoracic tumors, SFTs remain a diagnostic challenge. Reporting this case series highlights uncommon and diverse thoracic imaging presentations, illustrates the radiologic–pathologic correlation, and emphasizes the value of multimodality imaging in improving diagnostic confidence and guiding management. Case Presentation: This case series includes five Moroccan patients with thoracic solitary fibrous tumors, aged between 30 and 80 years, comprising both male and female patients. Clinical presentations ranged from incidental radiographic findings to respiratory symptoms such as dyspnea, chest pain, cough, or hemoptysis. Imaging assessment using chest radiography, computed tomography, and magnetic resonance imaging revealed large pleural-based or thoracic masses with heterogeneous enhancement and variable degrees of local invasion or mass effect. The diagnosis of solitary fibrous tumor was established in all cases by histopathological analysis following image-guided biopsy or surgical intervention. Management strategies included surgical resection or biopsy-guided diagnosis, and patients were referred for appropriate multidisciplinary management based on tumor behavior. Conclusion: This case series underscores the significant diagnostic variability of thoracic solitary fibrous tumors and highlights the essential role of cross-sectional imaging in their detection, characterization, and assessment of local extension. Awareness of the diverse imaging features of these rare tumors may improve diagnostic accuracy, facilitate appropriate multidisciplinary management, and contribute to better therapeutic decision-making and patient outcomes. Significance of the Study: Solitary fibrous tumors are rare entities and remain particularly challenging to diagnose in the thoracic region. This case series provides valuable insights that may assist researchers and clinicians in better understanding their presentation. The findings may also contribute to improved preoperative planning and highlight the essential role of multimodality imaging, particularly CT and MRI, in tumor characterization and classification.