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Background <p>Solitary fibrous tumor (SFT) is a rare benign neoplasm arising from fibrous connective tissue of the lung. These tumors are often asymptomatic and incidentally detected, but their radiologic appearance may resemble malignancies.</p> Case presentation <p>A 42-year-old male, former smoker, presented for routine post-COVID-19 imaging. Incidentally, a 38 × 35&#xa0;mm pulmonary mass was discovered posterior to the left pulmonary artery. The patient was asymptomatic, and physical exam findings were unremarkable. Initial CT and MRI suggested a benign lesion with no PET/CT radiotracer uptake. Despite initial radiological stability, the lesion demonstrated interval growth over 2.5 years, prompting video-assisted thoracoscopic surgical resection. Histopathology confirmed a SFT.</p> Conclusions <p>This case highlights the diagnostic challenges associated with slowly enlarging pulmonary masses that appear benign on imaging. It underscores the importance of long-term radiological surveillance and timely surgical evaluation when progressive growth is observed, even in PET-negative lesions, to prevent potential complications and definitively exclude malignancy.</p>

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Silent but suspicious: the clinical significance of slowly expanding PET-negative lung nodules

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月23日

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  • Ourania S. Kotsiou,
  • Xenia Salgami,
  • Konstantinos I. Gourgoulianis

摘要

Background

Solitary fibrous tumor (SFT) is a rare benign neoplasm arising from fibrous connective tissue of the lung. These tumors are often asymptomatic and incidentally detected, but their radiologic appearance may resemble malignancies.

Case presentation

A 42-year-old male, former smoker, presented for routine post-COVID-19 imaging. Incidentally, a 38 × 35 mm pulmonary mass was discovered posterior to the left pulmonary artery. The patient was asymptomatic, and physical exam findings were unremarkable. Initial CT and MRI suggested a benign lesion with no PET/CT radiotracer uptake. Despite initial radiological stability, the lesion demonstrated interval growth over 2.5 years, prompting video-assisted thoracoscopic surgical resection. Histopathology confirmed a SFT.

Conclusions

This case highlights the diagnostic challenges associated with slowly enlarging pulmonary masses that appear benign on imaging. It underscores the importance of long-term radiological surveillance and timely surgical evaluation when progressive growth is observed, even in PET-negative lesions, to prevent potential complications and definitively exclude malignancy.