Recurrent Pleural Solitary Fibrous Tumor: A Case Report and Brief Literature Review.

Background and Clinical Significance: Solitary fibrous tumors (SFTs) of the pleura are rare mesenchymal neoplasms accounting for less than 5% of pleuro-pulmonary tumors. Recurrence after complete resection of benign SFT is exceptional, with an estimated rate of approximately 3%. Case Presentation: We describe a 78-year-old woman who developed a late recurrence 10 years after resection of a giant benign pleural SFT. The new pleura-based mass was confirmed as SFT by CT-guided biopsy demonstrating spindle-cell morphology, patternless architecture, staghorn vasculature, and STAT6/CD34 positivity, consistent with intermediate-risk disease by Demicco scoring. Surgical tumorectomy was successfully performed. Conclusions: This case illustrates the unpredictable long-term behavior of pleural SFTs and reinforces the importance of extended imaging surveillance even in initially benign lesions. An updated review of contemporary classification systems, molecular mechanisms, and management strategies is included.