Solitary Fibrous Tumors of the Pleura With Extensive Intrathoracic Occupation: Report of Two Cases

Solitary fibrous tumors of the pleura (SFTPs) are rare mesenchymal neoplasms that typically originate from the visceral pleura. We report two cases of giant pleural SFTs involving the left hemithorax. The first case involved a 59-year-old woman presenting with two synchronous tumors, whereas the second case concerned a 39-year-old man with a single large intrathoracic mass. The coexistence of two distinct SFTs within the same hemithorax, as observed in the first patient, is exceptionally rare and may suggest a multicentric pleural origin or intrapleural dissemination. Both patients presented with progressive respiratory symptoms and mediastinal shift on chest computed tomography. Histopathological diagnosis was confirmed by percutaneous biopsy and immunohistochemical positivity for CD34, CD99, and BCL2. Complete tumor resection was achieved through posterolateral thoracotomy in both cases. One patient developed early postoperative recurrence during follow-up. These cases highlight the clinical heterogeneity of pleural SFTs and emphasize the diagnostic and surgical challenges posed by giant intrathoracic tumors. Accurate histopathological confirmation and complete surgical resection remain essential for optimal management, whereas long-term surveillance is warranted due to the potential risk of recurrence.