Abstract
A solitary fibrous tumor (SFT) is a rare neoplasm with a low metastatic rate. We report a case of a SFT with bone and pulmonary dissemination of an unusual presentation. A 69-year-old male presented with progressive rib pain of 2 years of evolution, which migrated to the ipsilateral lower extremity, progressively compromising its mobility. The diagnosis of SFT was confirmed by immunohistochemical analysis, and the presence of metastasis was suggested by imaging findings and confirmed by histopathological examination. This case shows an uncommon neoplasm with an atypical clinical presentation in terms of age, stage, and tumor behavior. Despite initial palliative measures and radiotherapy, the patient experienced worsening symptoms, including severe pain, limb shortening, scrotal edema, and anasarca. Chemotherapy with ifosfamide and doxorubicin was initiated but had to be discontinued due to cardiotoxicity and clinical decline, ultimately leading to the patient's death within less than a year from presentation.