1
|
Wu H, Hu X, Xiang W, Liu N, Fang S, Xu T, Qi Y, Zheng L, Cai W, Wu C, Yu H. A Large Solitary Fibrous Tumor of the Nasal Cavity and Paranasal Sinuses Involving the Anterior Frontal Fossa: A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2022:1455613221113809. [PMID: 35848410 DOI: 10.1177/01455613221113809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The Solitary Fibrous Tumor (SFT) is a rare mesenchymal neoplasm that arises mainly from the pleura. The sinonasal tract is generally not affected by SFT, and less than 100 cases have been reported in the English literature to date. We report an extremely rare SFT of the nasal cavity and paranasal sinuses extending into the anterior frontal fossa through the floor of the anterior skull base. To our knowledge, this case is the fourth SFT of the sinonasal tract involving the anterior frontal fossa in the world. Meanwhile, the tumor, measuring 13 × 6 cm in images, is the largest SFT of the sinonasal tract compared to previously reported cases. Three surgical procedures, including a transcranial one, were performed for the patient to achieve complete removal of the tumor. The diagnosis of SFT was established primarily by immunohistochemical positivity for CD34, STAT6, and negativity for S-100 protein. We emphasize the possibility of recurrence in SFT, and close follow-up is necessary with the help of nasal endoscopy and imaging approaches.
Collapse
Affiliation(s)
- Huachao Wu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaoyan Hu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wenbin Xiang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Nuomin Liu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Sha Fang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ting Xu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Qi
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Linhui Zheng
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wenqi Cai
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chaoyan Wu
- Department of Traditional Chinese Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Haijun Yu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
2
|
Sinonasal Tract Solitary Fibrous Tumor: A Clinicopathologic Study of Six Cases with a Comprehensive Review of the Literature. Head Neck Pathol 2017; 12:471-480. [PMID: 29282671 PMCID: PMC6232205 DOI: 10.1007/s12105-017-0878-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/12/2017] [Indexed: 12/17/2022]
Abstract
Solitary fibrous tumors (SFTs) are well recognized in the head and neck region, but rarely arise in the sinonasal tract (SNT). Six primary SNT SFTs were identified in the files of Southern California Permanente Medical Group between 2006 and 2017. The patients included five males and one female ranging in age from 33 to 72 years (mean 52 years), most of whom presented clinically with nasal obstruction. Three tumors involved the nasal cavity alone, one involved the paranasal sinuses, and two involved both the nasal cavity and paranasal sinuses. Histologically, the tumors were characterized by a variably cellular proliferation of cytologically bland spindle cells within a collagenous stroma with prominent interspersed branching vessels. Mitotic activity was low (range 0-2 per 10 high power fields) and there was no evidence of pleomorphism or tumor necrosis. Surface ulceration was noted. By immunohistochemistry, the lesional cells were positive for CD34, STAT6 and bcl-2. Clinical follow up information was available for all patients (range 32-102 months; mean 72 months). There were no recurrences or metastases and all were alive with no evidence of disease at last follow-up. SFTs rarely affect the SNT, but should be considered in the differential diagnosis of SNT mesenchymal lesions. Immunohistochemical expression of STAT6 can aid in diagnosis and separation of SFT from other spindle cell lesions occurring at this anatomic site. In combination with cases reported in the literature, primary SNT SFT behave in an indolent manner with conservative treatment.
Collapse
|
3
|
Rizzo S, Giunta AAM, Pennacchi A. Sinonasal and rhinopharyngeal solitary fibrous tumour: a case report and review of the literature. ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 35:455-8. [PMID: 26900253 PMCID: PMC4755049 DOI: 10.14639/0392-100x-163813] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Solitary fibrous tumours are rare neoplasms that arise mostly from the pleura. Much more rarely they can also be found in extrapleural sites, including the head and neck. We report a rare case of a sinonasal and rhinopharyngeal solitary fibrous tumour. The tumour, measuring 67 x 28 x 55 mm, was first embolised and then successfully removed through endonasal endoscopic surgery. Histopathologic analysis confirmed the nature of the lesion, which was positive for CD34 and vimentin. A post-operative CT scan and endoscopic follow-up demonstrated total resection and absence of recurrence after 13 months.
Collapse
Affiliation(s)
- S Rizzo
- Department of Otorinolaryngology-Head and Neck Surgery Santa Maria Hospital of Terni, Italy
| | - A A M Giunta
- Department of Otorinolaryngology-Head and Neck Surgery Santa Maria Hospital of Terni, Italy
| | - A Pennacchi
- Department of Otorinolaryngology-Head and Neck Surgery Santa Maria Hospital of Terni, Italy
| |
Collapse
|
4
|
Park ES, Kim J, Jun SY. Characteristics and prognosis of glomangiopericytomas: A systematic review. Head Neck 2017; 39:1897-1909. [DOI: 10.1002/hed.24818] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/07/2016] [Accepted: 04/07/2017] [Indexed: 12/12/2022] Open
Affiliation(s)
- Eun Su Park
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
| | - Jiyoung Kim
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
| | - Sun-Young Jun
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
| |
Collapse
|
5
|
Fujikura T, Ishida M, Sekine K, Aoki H, Okubo K. Solitary fibrous tumor arising from the superior nasal turbinate: a case report. J NIPPON MED SCH 2013; 79:373-6. [PMID: 23123395 DOI: 10.1272/jnms.79.373] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Solitary fibrous tumor is a rare neoplasm, which was first described as a primary spindle-cell tumor of the pleura, is a type of mesenchymal tumor. Although the majority of these tumors originate in the pleura, they can also derive from extrapleural sites, such as the liver, lung, abdomen, and extremities. We report a rare case of a nasal solitary fibrous tumor that originated from the nasal superior turbinate. The tumor, measuring 45 × 25 × 10 mm, was in the right nasal cavity. We successfully removed the tumor in one piece through endonasal endoscopic surgery. The tumor had spindle-shaped cells within a collagenous stroma and was positive for CD34. There has been no evidence of tumor recurrence in the 14 months following surgery.
Collapse
Affiliation(s)
- Terumichi Fujikura
- Department of Head & Neck and Sensory Organ Science, Graduate School of Medicine, Nippon Medical School, Sendagi, Bunkyo-ku, Tokyo, Japan.
| | | | | | | | | |
Collapse
|
6
|
Yang BT, Song ZL, Wang YZ, Dong JY, Wang ZC. Solitary fibrous tumor of the sinonasal cavity: CT and MR imaging findings. AJNR Am J Neuroradiol 2013; 34:1248-51. [PMID: 23413243 DOI: 10.3174/ajnr.a3485] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY SFT is a rare lesion of the sinonasal cavity. We retrospectively reviewed 5 patients with histopathologically proved sinonasal SFTs to determine their CT and MR imaging features. All patients underwent paranasal sinus CT and MR imaging. Four SFTs occurred in the nasal cavity, and 1, in the maxillary sinus. All SFTs had well-defined margins, and the mean maximum diameter was 55 mm. On nonenhanced CT, 5 SFTs appeared homogeneously isoattenuating to gray matter. The most common manifestations of bony involvement were bony remodeling and thinning. On MR imaging, 5 SFTs were isointense to gray matter on T1-weighted images, and the lesions were isointense in 3 and hypointense in 2 patients on T2-weighted images. The lesions showed heterogeneously marked enhancement on postenhanced MR images. Four patients underwent dynamic contrast-enhanced MR imaging, and the TICs showed a washout pattern. A familiarity with the imaging findings of sinonasal SFT may help to diagnose this entity.
Collapse
Affiliation(s)
- B T Yang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | | | | | | |
Collapse
|
7
|
Janjua A, Sklar M, Macmillan C, Vescan A, Witterick IJ. Endoscopic resection of solitary fibrous tumors of the nose and paranasal sinuses. Skull Base 2012; 21:129-34. [PMID: 22451814 DOI: 10.1055/s-0031-1275259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Solitary fibrous tumors (SFTs) are uncommon neoplasms of mesenchymal origin that were first described as primary spindle-cell tumors of the pleura in 1931. Since then, infrequent case reports of extrapleural SFTs have been described including various subsites within the head and neck. Based on a review of the literature and a description of the endoscopic treatment of three patients with SFTs of the nasal cavity and ethmoid sinuses, the challenges associated with the management of sinonasal SFTs are discussed. Successful endoscopic resection was performed at a tertiary referral rhinology practice within a university center in three cases of sinonasal SFTs with no evidence of recurrence at 26, 35, and 49 months following resection. Summarized are the common presenting symptoms, appropriate diagnostic workup, and indicative computed tomography and magnetic resonance imaging appearance of SFTs. Further discussed are the challenge associated with accurate histological and immunohistochemical diagnosis, the difficulty in assessing the aggressiveness and malignant potential of these lesions, and the appropriate treatment and follow-up duration that these neoplasms require.
Collapse
|
8
|
Solitary fibrous tumor of the central nervous system: a 15-year literature survey of 220 cases (August 1996-July 2011). Adv Anat Pathol 2011; 18:356-92. [PMID: 21841406 DOI: 10.1097/pap.0b013e318229c004] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We reviewed the world literature on solitary fibrous tumors of the central nervous system from August 1996 to July 2011, focusing on both clinicopathological features and diagnostic findings. The anatomical distribution of the 220 cases reported so far reveals that most are intracranial and just over one-fifth are intraspinal. In decreasing frequency, intracranial tumors involve the supratentorial and infratentorial compartments, the pontocerebellar angle, the sellar and parasellar regions, and the cranial nerves. Intraspinal tumors are mainly located in the thoracic and cervical segments. Although most solitary fibrous tumors of the central nervous system are dural based, a small subset presents as subpial, intraparenchymal, intraventricular, or as tumors involving the nerve rootlets with no dural connection. Preoperative imaging and intraoperative findings suggest meningioma, schwannoma or neurofibroma, hemangiopericytoma, or pituitary tumors. Immunohistochemistry is critical to establish a definitive histopathological diagnosis. Vimentin, CD34, BCL2, and CD99 are the most consistently positive markers. The usual histologic type generally behaves in a benign manner if complete removal is achieved. Recurrence is anticipated when resection is subtotal or when the tumor exhibits atypical histology. The proliferative index as assessed by MIB1 labeling is of prognostic significance. Occasionally, tumors featuring conventional morphology may recur, perhaps because of minimal residual disease left behind during surgical extirpation. Rare extracranial metastases and tumor-related deaths are on record. Surgery is the treatment of choice. Stereotactic and external beam radiation therapy may be indicated for postsurgical tumor remnants and for unresectable recurrences. Long-term active surveillance of the patients is mandatory.
Collapse
|
9
|
Bisceglia M, Dimitri L, Giannatempo G, Carotenuto V, Bianco M, Monte V, D’Angelo V, Magro G. Solitary Fibrous Tumor of the Central Nervous System. Int J Surg Pathol 2011; 19:476-86. [DOI: 10.1177/1066896911405655] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Solitary fibrous tumor (SFT) of the central nervous system was first described in 1996. A number of cases have been reported since. The authors present 5 new cases: 4 intracranial and 1 intraspinal. All patients were adults (age range, 47 to 75 years); 4 were male and 1 female; 4 cases were primary tumors; and 1 was a second tumor recurrence. All patients were surgically treated with gross total removal. All cases were histologically examined with immunohistochemical confirmation; 2 tumors exhibited diffuse classic histology, 1 tumor was a cellular variant, 1 tumor was myxoid, and 1 was predominantly classic with focal myxoid features and focally pleomorphic. The postoperative course was uneventful in all. The patient with the cellular variant experienced 2 local recurrences and eventually died of disease 10 years after the initial diagnosis. The patient with the myxoid variant—the tumor studied—which was the second recurrence of a previously misdiagnosed fibrous meningioma surgically treated 15 years earlier, had a recurrence after 2 years for the third time and eventually died of disease. Three patients are alive and well 11.6, 6, and 4 years after surgery. SFT is a rare tumor that needs to be differentiated from some mimickers, mainly fibrous meningioma, hemangiopericytoma, and with regard to the myxoid variant, also adult-onset myxochordoid meningioma and myxoid peripheral nerve sheath tumor. Immunohistochemistry is crucial for the correct diagnosis of SFT. The authors also performed a review of the literature and found a little more than 200 cases on record.
Collapse
Affiliation(s)
- Michele Bisceglia
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Lucia Dimitri
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | | | - Vincenzo Carotenuto
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Mario Bianco
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Vincenzo Monte
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Vincenzo D’Angelo
- IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Gaetano Magro
- University and Polyclinic Hospital of Catania, Catania, Italy
| |
Collapse
|
10
|
Cox DP, Daniels T, Jordan RCK. Solitary fibrous tumor of the head and neck. ACTA ACUST UNITED AC 2010; 110:79-84. [PMID: 20488732 DOI: 10.1016/j.tripleo.2010.01.023] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 12/18/2009] [Accepted: 01/26/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to review the reported cases of solitary fibrous tumor (SFT) in the head and neck and to evaluate this tumor regarding histologic features, treatment, and recurrence. SFT has been described in many extrapleural sites, including the head and neck. Uniform overexpression of CD34 differentiates SFT from other spindle cell neoplasms. SFT is a slow-growing neoplasm that can be successfully treated by complete excision. A rare malignant counterpart has also been described. STUDY DESIGN In this case series and review of published cases from English-language journals in the National Library of Medicine, we reviewed 142 cases of SFT reported in English-language literature and add 11 new cases. We compared the features reported in the previous publications of SFT from the head and neck with our series, including cases described as malignant or atypical SFT. RESULTS Four out of 9 cases with positive margins recurred, whereas only 1 out of 10 cases with atypical or malignant features recurred. CONCLUSIONS An important finding in SFT of the head and neck is that recurrence appears more related to incomplete excision than to microscopic grade.
Collapse
Affiliation(s)
- Darren P Cox
- Department of Orofacial Sciences, University of California, San Francisco, California 94143-0424, USA.
| | | | | |
Collapse
|
11
|
Yamaguchi N, Komuro S, Kumagami H, Iwanaga T, Takahashi H. Laryngeal Solitary Fibrous Tumor Treated with a Transcervical Approach. Otolaryngol Head Neck Surg 2009; 141:790-1. [DOI: 10.1016/j.otohns.2009.03.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 03/19/2009] [Accepted: 03/30/2009] [Indexed: 01/23/2023]
Affiliation(s)
- Nimpei Yamaguchi
- Department of Otorhinolaryngology–Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Satoru Komuro
- Department of Otorhinolaryngology–Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hidetaka Kumagami
- National Hospital Organization Nagasaki Medical Center, and the Department of Otolaryngology–Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tetsu Iwanaga
- Department of Otorhinolaryngology–Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Haruo Takahashi
- National Hospital Organization Nagasaki Medical Center, and the Department of Otolaryngology–Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
12
|
Takasaki K, Watanabe T, Hayashi T, Kinoshita N, Kumagami H, Takahashi H. Solitary fibrous tumor arising from the sphenoid sinus. Case Rep Med 2009; 2009:316042. [PMID: 19724637 PMCID: PMC2728605 DOI: 10.1155/2009/316042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Accepted: 08/03/2009] [Indexed: 11/25/2022] Open
Abstract
Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. To our knowledge, only 30 cases of SFTs in the nasal cavity and paranasal sinuses have been reported in the literature. We describe an SFT that arose from the right sphenoid sinus and extended to the nasal cavity and epipharynx. The tumor was completely removed by endoscopic sinus surgery without complication. The patient is taking an uneventful course without any evidence of recurrence of the disease 8 months after surgery now.
Collapse
Affiliation(s)
- Kenji Takasaki
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Takeshi Watanabe
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomayoshi Hayashi
- Department of Pathology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Naoe Kinoshita
- Department of Pathology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hidetaka Kumagami
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Haruo Takahashi
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| |
Collapse
|
13
|
Kodama S, Fujita K, Suzuki M. Solitary fibrous tumor in the maxillary sinus treated by endoscopic medial maxillectomy. Auris Nasus Larynx 2009; 36:100-3. [DOI: 10.1016/j.anl.2008.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 12/04/2007] [Accepted: 01/15/2008] [Indexed: 10/22/2022]
|
14
|
Minimally invasive endoscopic techniques for treating large, benign processes of the nose, paranasal sinus, and pterygomaxillary and infratemporal fossae: solitary fibrous tumour. The Journal of Laryngology & Otology 2008; 123:457-61. [PMID: 18405404 DOI: 10.1017/s0022215108002132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We report an extremely rare case of a large solitary fibroma of the paranasal sinus, which we treated by sinonasal endoscopic surgery. We describe its clinical and histopathological features, and we report the endoscopic technique used to deal with such a large sinonasal mass (penetrating the pterygomaxillary and infratemporal fossae); we also offer a brief survey of the literature. CASE REPORT A woman presented with an approximately one-year history of nasal obstruction. Nasal endoscopy revealed an irregularly shaped, friable, reddish mass that occupied the whole of the right nasal fossa. Magnetic resonance imaging of the paranasal sinuses revealed a large mass that occupied the anterior and posterior ethmoids and the maxillary and sphenoid sinuses, displacing the septum and penetrating the pterygomaxillary fossa, having destroyed the lateral wall of the right nasal fossa. The tumour was resected by means of sinonasal endoscopic surgery; an endoscopic medial maxillectomy with extension to the pterygomaxillary and infratemporal regions was performed. Histological analysis confirmed the diagnosis of solitary fibrous tumour. During follow up, we performed regular nasal endoscopies, as well as computed tomography scans one and six months post-operatively. CONCLUSIONS Endoscopic techniques are currently the approach of choice for the treatment of such tumours of the sinonasal cavity and pterygomaxillary and infratemporal regions. The size of the lesion did not contraindicate endoscopic sinonasal surgery as a curative treatment.
Collapse
|