MRI Findings of a Malignant Solitary Fibrous Tumor of the Diaphragmatic Pleura: a Case Report

Solitary fibrous tumors (SFT) are rare mesenchymal tumors that most commonly develop in the pleura; they rarely involve the diaphragm. MRI has not been widely used to evaluate SFTs of the thoracic cavity, though it may be highly useful in assessing local invasion, predicting malignant potential, and helping in the differential diagnosis. However, MRI findings of malignant SFTs of the diaphragmatic pleura have been described in only two cases. We report a rare case of a malignant solitary fibrous tumor of the diaphragmatic pleura in an 82-year-old man. We describe the clinical and characteristic imaging features, including computed tomography, conventional MRI, and diffusion-weighted imaging. Contrast-enhanced MRI is more accurate than is CT in identifying the origin of SFTs, predicting whether they ae benign or malignant, and assessing local invasion. This imaging modality proved helpful in deciding on the treatment strategy for these rare tumors.