Solitary fibrous tumor of the pleura is typically which of the following?

• A. Large pedunculated mass arising from the visceral pleura
• B. Diffuse pleural thickening
• C. Pulmonary embolism
• D. Malignant lesion with rapid progression

Answer: (A)

Solitary fibrous tumor of the pleura most often presents as a single, well-defined mass that is attached to the visceral pleura by a pedicle. This pedunculated, pleural-based growth is the classic imaging and clinical clue to its origin from the visceral pleura and its tendency to form a discrete, sometimes mobile tumor rather than a diffuse process. Diffuse pleural thickening points toward conditions like mesothelioma or inflammatory disease, not a solitary mass. A pulmonary embolism is a vascular issue, not a mass lesion. While these tumors can be malignant in a minority and may grow slowly, the typical presentation is a large, pedunculated mass arising from the visceral pleura, making that option the best match.