Giant solitary fibrous tumor of the pleura causing respiratory insufficiency: report of 3 cases.

We present 3 cases of solitary fibrous tumors (SFTs) occupying entire hemithorax and resulting in respiratory insufficiency. All patients were treated by complete resection, resulting in immediate re-expansion of the lungs and recovery from respiratory insufficiency. Although, two patients remain alive without recurrence, one patient had pleural recurrences three times over a 20-year period, all of which were treated by surgical resection. All of the primary tumors exhibited areas of hypercellularity, hemorrhage, or necrosis. All of the recurrent tumors in the recurrent case displayed large areas of hypercellularity, similar to the part of primary tumor. Although, the MIB-1 index in primary tumors was less than 5%, the index of the recurrent tumors increased up to 11% with repeated recurrence. Giant SFTs usually display hypercellularity, hemorrhage, or necrosis. Tumors with hypercellularity could recur. MIB-1 index could display malignant characteristics of recurrent tumors. Long-term follow-up for more than 10 years after surgery is necessary, particularly for tumors with areas of hypercellularity.