Diagnosis and surgical treatment for complex solitary fibrous tumor in the mediastinum

Objective To investigate the clinical features,diagnosis and surgical treatment of complex mediastinum solitary fibrous tumor(SFT),and analyze the conditions of treatment and prognosis of such diseases. Methods The clinical data of three complex mediastinum SFT patients confirmed by postoperative pathology and immunohistochemistry in our hospital between May 2014 and June 2015 were analyzed retrospectively.The follow-up materials were reviewed.The main clinical manifestation of these three patients included the irritating dry cough in one patients,chest tightness and shortness of breath in one patient,and chest discomfort in one case.The enhanced chest CT examination was performed in all patients before the operation.No metastasis and other surgical contraindications were found.The proper surgical method was selected according to the location of the tumor.The operation methods included:left posterior-inferior mediastinum tumor was cut via the left for tumor resection;left posterior-inferior mediastinum tumor via left for tumor resection and with left-lower lobectomy;inferior-right-posterior mediastinum tumor resection via right into the chest,mark the serious part with titanium clip,and postoperative four weeks for radiotherapy.The examinations in follow up included one month later review of chest X-ray,3 to 6 months after the operation for the chest CT,and 1 to 3 years after the operation for one time of chest CT yearly. Results All patients were operated successfully,and the tumor was resected completely.Among them,one patient had more serious chest tightness,which was improved after the symptomatic treatment.All of the 3 patients were followed up,and no recurrence and metastasis during the follow-up period. Conclusion Complex mediastinum SFT is a rare mediastinal tumor,diagnosis should be made by pathology and immunohistochemistry analysis,surgical treatment is the first choice,with complete resection and good prognosis,and close follow-up is required,for the severe postoperative invasion,neoadjuvant radiotherapy is required.