Mediastinal solitary fibrous tumor diagnosed by endobronchial ultrasound-directed biopsy

Alaina J. Webb, Ahmed S. Yassin, Ali Saeed, Hemang Yadav, James P Utz

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Rare disease Background: Solitary fibrous tumors of the middle mediastinal space are uncommon and often not discovered until symptoms secondary to compression of adjacent structures occur. Diagnosis requires surgical biopsy and histological tissue analysis. We describe the ECHO appearance of the solitary fibrous tumor and successful non-invasive EBUS diagnosis. This method of diagnosis allowed for surgical planning for resection and allowed us to exclude non-surgical diseases, such as small cell carcinoma. Case Report: A 32-year-old man presented to his primary care physician with worsening intermittent chronic chest pain with recent progressive dysphagia, cough, and dyspnea. Physical examination and routine laboratory work-up were unrevealing. Chest radiograph and computed tomography (CT) of the chest revealed a middle mediastinal mass. Flexible bronchoscopy confirmed extrinsic compression of right and left bronchial trees. Endobronchial ultrasound (EBUS) was used to biopsy the mass and the diagnosis of solitary fibrous tumor was confirmed. The patient underwent successful tumor resection and was discharged home after an uneventful postoperative period. Conclusions: Endobronchial ultrasound-directed tissue biopsy is an appropriate modality for suspected solitary fibrous tumors of the mediastinum. To our knowledge, this is only the second reported case of SFT diagnosed by EBUSTBNA. Our case uniquely demonstrates the advantages of pre-surgical diagnosis of mediastinal masses with EBUS-TBNA when the diagnosis SFT is suggested on CT and US imaging.

Original languageEnglish (US)
Pages (from-to)549-552
Number of pages4
JournalAmerican Journal of Case Reports
Volume18
DOIs
StatePublished - May 18 2017

Fingerprint

Solitary Fibrous Tumors
Biopsy
Thorax
Tomography
Small Cell Carcinoma
Mediastinum
Primary Care Physicians
Bronchoscopy
Deglutition Disorders
Rare Diseases
Chest Pain
Cough
Postoperative Period
Chronic Pain
Dyspnea
Physical Examination

Keywords

  • Biopsy
  • Bronchoscopes
  • Fine-needle
  • Mediastinal neoplasms
  • Solitary fibrous tumors
  • Ultrasonography

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mediastinal solitary fibrous tumor diagnosed by endobronchial ultrasound-directed biopsy. / Webb, Alaina J.; Yassin, Ahmed S.; Saeed, Ali; Yadav, Hemang; Utz, James P.

In: American Journal of Case Reports, Vol. 18, 18.05.2017, p. 549-552.

Research output: Contribution to journalArticle

Webb, Alaina J. ; Yassin, Ahmed S. ; Saeed, Ali ; Yadav, Hemang ; Utz, James P. / Mediastinal solitary fibrous tumor diagnosed by endobronchial ultrasound-directed biopsy. In: American Journal of Case Reports. 2017 ; Vol. 18. pp. 549-552.
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abstract = "Objective: Rare disease Background: Solitary fibrous tumors of the middle mediastinal space are uncommon and often not discovered until symptoms secondary to compression of adjacent structures occur. Diagnosis requires surgical biopsy and histological tissue analysis. We describe the ECHO appearance of the solitary fibrous tumor and successful non-invasive EBUS diagnosis. This method of diagnosis allowed for surgical planning for resection and allowed us to exclude non-surgical diseases, such as small cell carcinoma. Case Report: A 32-year-old man presented to his primary care physician with worsening intermittent chronic chest pain with recent progressive dysphagia, cough, and dyspnea. Physical examination and routine laboratory work-up were unrevealing. Chest radiograph and computed tomography (CT) of the chest revealed a middle mediastinal mass. Flexible bronchoscopy confirmed extrinsic compression of right and left bronchial trees. Endobronchial ultrasound (EBUS) was used to biopsy the mass and the diagnosis of solitary fibrous tumor was confirmed. The patient underwent successful tumor resection and was discharged home after an uneventful postoperative period. Conclusions: Endobronchial ultrasound-directed tissue biopsy is an appropriate modality for suspected solitary fibrous tumors of the mediastinum. To our knowledge, this is only the second reported case of SFT diagnosed by EBUSTBNA. Our case uniquely demonstrates the advantages of pre-surgical diagnosis of mediastinal masses with EBUS-TBNA when the diagnosis SFT is suggested on CT and US imaging.",
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