PMC2892660_01
Solitary fibrous tumour of the anterior thoracic wall.
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On physical examination, the tumour appeared as an exophytic pseudolobulated tan-pink mass, measuring 18 x 10 cm, with multiple hemorrhagic foci, yellow and black necrosis, and localized infection with purulent exudates (Figure 1).
Tumour specimen after resection.
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The patient underwent wide local resection of the tumour by a surgical team consisting of thoracic and plastic surgeons (Figure 2).
Immediate postoperative result after tumour resection and reconstruction with bilateral pectoralis major advancement flaps and split-thickness skin graft.
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For the reconstruction of the wide defect both pectoralis major advancement flaps were mobilized and covered with a partial-thickness skin graft (Figure 3). 
Malignant solitary fibrous tumour demonstrating patternless arrangement of spindle cells and areas with very high cellularity. The spindle cells have moderate cytological atypia, and three mitoses in mitotically active fields are evident (HE x400).
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Microscopically spindle cells were arranged patternless, with a characteristic hemangiopericytoma-like morphology, and there were areas with very high cellularity (Figures 4 and 5).
(a) Malignant solitary fibrous tumour demonstrating uniform immunoreactivity for CD34 (CD34 x400) with hemangiopericytoma-like morphology. (b) A hyalinized vessel with thrombus in it is evident (HE x200), as well as (c) hyalinized staghorn vessels of tumour, that are centered (CD34 x200). (d) Areas of hypo- and hypercellularity (HE x200) are evident.
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fig5
Microscopically spindle cells were arranged patternless, with a characteristic hemangiopericytoma-like morphology, and there were areas with very high cellularity (Figures 4 and 5).