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Solitary fibrous tumours of the pleura are rare. They are mesenchymal in origin. Initially, they were described in the pleura, but lately they have been reported in many other sites. Although the majority of these tumours are benign, some of them are malignant. Their unpredictable clinical course is probably related to their histological and morphological characteristics. The benign tumours may remain unproblematic for several years before changing into a malignant form. In order to define more accurately the clinical behaviour, diagnosis, management and outcome of these rare tumours, we reviewed the literature with particular attention to clinical presentation, methods of diagnosis, treatment and outcome. Furthermore, a modified algorithm was proposed for the management of these tumours.