Incidentally detected multifocal calcifying fibrous tumour of the pleura: a diagnostic enigma

Calcifying fibrous tumour of the pleura (CFTP) is a rare, benign soft tissue neoplasm with uncertain aetiology. To our knowledge, only 36 cases (including this case) have been reported in English literature. A man in his early 30s presented with an incidental pleural lesion identified following investigation for a persistent cough. Imaging revealed left pleural thickening with calcification, raising concern for a possible malignant pleural process. CT-guided biopsy demonstrated fibrosis without malignancy, and a video-assisted thoracoscopic surgery excision was performed. Histopathology confirmed multifocal CFTP. This case highlights the diagnostic challenges posed by pleural-based calcified lesions and reinforces the importance of surgical excision for both diagnosis and cure. The rarity of CFTPs, their benign course and their potential to mimic malignancy are discussed alongside a review of the current literature.