1
|
Vijayasundaram S, Agathiyanathan V, Karthikeyan P, Ravichandran K. Benign Spindle Cell Lesion of the Nasal Cavity: A Rare Presentation of Solitary Fibrous Tumor. Cureus 2024; 16:e60220. [PMID: 38868242 PMCID: PMC11168749 DOI: 10.7759/cureus.60220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 06/14/2024] Open
Abstract
Solitary fibrous tumors (SFTs) are rare neoplasms primarily found in the pleural region but have been documented in diverse extrapleural sites, including the nasal cavity and paranasal sinuses, albeit infrequently. Here, we present a case of a 48-year-old female who presented with a right-sided nasal mass and associated ophthalmologic symptoms, ultimately diagnosed with a benign spindle cell lesion localized to the nasal cavity. The patient underwent a comprehensive evaluation involving clinical examination, radiological imaging, and histopathological analysis, leading to the identification of a benign solitary fibrous tumor. Notably, diagnosing SFTs in the nasal cavity presents challenges due to their nonspecific clinical and imaging features, necessitating a multidisciplinary approach for accurate diagnosis and optimal management. Surgical excision, preferably via endoscopic techniques, remains the cornerstone of treatment based on tumor characteristics and extent. This case underscores the importance of recognizing uncommon presentations of sinonasal lesions, navigating diagnostic complexities, and emphasizing the critical role of multidisciplinary collaboration in achieving favorable treatment outcomes for patients with such nasal cavity tumors.
Collapse
Affiliation(s)
- S Vijayasundaram
- Otolaryngology - Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, IND
| | | | - Padmanabhan Karthikeyan
- Otolaryngology - Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, IND
| | - Kirubhagaran Ravichandran
- Otolaryngology - Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, IND
| |
Collapse
|
2
|
Arnous NK, Alkholaiwi F, Alrasheed AS. Sinonasal Glomangiopericytoma with Skull Base Involvement: A Diagnostic Dilemma. EAR, NOSE & THROAT JOURNAL 2024:1455613231223900. [PMID: 38229414 DOI: 10.1177/01455613231223900] [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: 01/18/2024] Open
Abstract
Introduction: Glomangiopericytoma (GPC) is a rare type of neoplasm with hemangiopericytoma-like vasculature and perivascular hyalinization of capillary-sized veins. CD34 and S100 protein staining might be positive in a small percentage of GPC. Solitary fibrous tumors (SFTs) present clinically like GPC. However, challenges remain when differentiating GPC from SFT. Case Presentation: A 37-year-old male, smoker, presented with 3 years history of right-sided epistaxis and nasal congestion. He was also complaining of hyposmia but no headaches or visual complaints. On nasal endoscopy, he was found to have a right-sided nasal mass occupying the ethmoid cavity. Computed tomography showed a right sinonasal mass abutting the anterior skull base and magnetic resonance imaging demonstrated a hyperintense, enhancing mass within the right ethmoid cavity, superior septum, and anterior skull base. The patient underwent endoscopic resection with gross total resection and skull base reconstruction. Postoperative pathology initially was thought to be an SFT; however, subsequent STAT6 expression was negative, and therefore GPC diagnosis was confirmed. At the most recent follow-up (6 months), the patient remained free of local disease. Discussion: SFT, unlike GPC, stains strongly for CD34, in this case, due to strong CD34, the diagnosis of SFT was initially made. Nuclear STAT6 expression is highly specific and sensitive for SFT. This later returned as negative; therefore, GPC was confirmed. Conclusion: We present a case of sinonasal GPC with skull base involvement that was treated with endoscopic resection. At the most recent follow-up (6 months), the patient remained free of local disease.
Collapse
Affiliation(s)
| | - Feras Alkholaiwi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulaziz S Alrasheed
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
3
|
Dwivedi G, Ranganathan Y, Bandopadhyay A, Mukherjee T. Solitary Fibrous Tumor of Parapharyngeal Space: A Rare Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1152-1156. [PMID: 37275014 PMCID: PMC10235249 DOI: 10.1007/s12070-022-03439-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023] Open
Abstract
Solitary fibrous tumors are rare vascular tumours, earlier referred to as hemangiopericytoma. Their occurrence in parapharyngeal space is very rare. Hence, they should also be considered in the differential diagnosis of parapharyngeal soft tissue tumours. This case is being reported to bring out an extremely rare vascular tumour at rare site and represents a surgical challenge because of difficult access in parapharyngeal space with difficult planes between tumour and rest of parapharyngeal space, approach to it is also difficult.
Collapse
Affiliation(s)
- Gunjan Dwivedi
- Department of ENT, Command Hospital Eastern Command, 17/1E, Alipore Main Road, Alipore, Kolkata, 700027 India
| | - Yamuna Ranganathan
- Department of ENT, Command Hospital Eastern Command, 17/1E, Alipore Main Road, Alipore, Kolkata, 700027 India
| | - Arnab Bandopadhyay
- Department of Surgical Oncology, Command Hospital Eastern Command, Kolkata, India
| | - Tanushri Mukherjee
- Department of Pathology, Command Hospital Eastern Command, Kolkata, India
| |
Collapse
|
4
|
Boschetti CE, Vitagliano R, Imola G, Cornacchini N, Colella ML, Tartaro G, Colella G. Solitary Extrapleural Fibrous Tumor in Salivary Glands: Our Experience-Case Series and Literature Review. Diagnostics (Basel) 2022; 12:2688. [PMID: 36359531 PMCID: PMC9688987 DOI: 10.3390/diagnostics12112688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/22/2022] [Accepted: 11/02/2022] [Indexed: 09/22/2023] Open
Abstract
(1) Background: Extrapleural solitary fibrous tumors (ESFTs) are rare oncological entities occurring in the head and neck, and even more so in the salivary glands. The clinical presentation and histologic features are usually unspecific, resulting in frequent misclassification. As an unusual tumor, ESTFs have an unpredictable clinical behavior. (2) Methods: We present two clinical cases referred to our Maxillofacial Surgery Unit for the onset of a symptomless mass involving, in one case, the parotid gland, and in the other case, the sublingual gland. (3) Results: Solitary fibrous tumors could be considered as neoplasms with intermediate biological behavior that are not entirely predictable on the basis of morphological features, as these are mostly still unknown. However, a few histologic, immunohistochemical, and imaging features, such as a hypodense signal at the T1 sequence in an MRI, or positivity for CD34, bcl2, and CD99, and the NAB2-STATS6 fusion gene, could be useful for an early differential diagnosis of ESTFs. (4) Conclusions: All patients were alive at follow-up with no evidence of disease. Surgical management should always be considered as the first choice for oncological radicality, and clinical behavior should always be defined with the help of the study of radiological and anatomopathological features.
Collapse
Affiliation(s)
| | - Rita Vitagliano
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Special- 8 ties, University of Campania “Luigi Vanvitelli”, Via Luigi de Crecchio, 6, 80138 Naples, Italy
| | | | | | | | | | | |
Collapse
|
5
|
Yang F, Zhou LQ, Chen JC, Chen S, Zhou DW, Zhong G, Wang YJ. Solitary Fibrous Tumor of the Paranasal Sinuses with Intracranial Extension: A Rare Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2022:1455613221135646. [PMID: 36289009 DOI: 10.1177/01455613221135646] [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: 12/22/2023] Open
Abstract
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that were initially identified in the pleura. SFTs in the nasal or paranasal sinuses are especially rare. Most SFTs exhibit indolent behavior, with a low local recurrence rate. A 39-year-old man complained of bilateral nasal congestion, hyposmia, and occasional right eye tears six months prior to hospitalization. Based on MRI and CT imaging, a total gross surgical resection was achieved. Subsequently, postsurgical histopathological examinations were conducted. Under the microscope, pathological mitotic bodies were visible (<5 mitoses per 2 mm2). The immunohistochemical staining results revealed that tumor cells were positive for CD34, BCL-2, STAT-6, and Ki-67 (<5%) but negative for EMA, S-100, PR, GFAP, and SMA. Based on these findings, the patient was diagnosed with SFT.
Collapse
Affiliation(s)
- Fan Yang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu-Qing Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing-Cai Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shan Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Di-Wei Zhou
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Zhong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
6
|
Khribi M, Wassim K, Abir M, Sriha B, Bellakhdhar M, Abdelkefi M. Solitary Fibrous tumor of Nasal cavity: A case report and review of literature. Int J Surg Case Rep 2022; 93:106950. [PMID: 35358762 PMCID: PMC8968015 DOI: 10.1016/j.ijscr.2022.106950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/09/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction and importance Solitary fibrous tumors (SFTs) involving the nasal cavity are extremely rare with few cases reported in the literature. Case presentation We present a case of SFT in a 90 year-old male complaining of a slow-growing mass prolapsing through left nostril. Nasal endoscopy and imaging exams revealed a mass occupying the entire left nasal cavity, pushing the nasal septum to the opposite side and extending up to the nasopharynx. Biopsy specimen examination reported sarcoma. The patient underwent complete surgical resection of the mass through left para-latero-nasal approach. Immuno-histochemical analyses confirmed the diagnosis of SFT. The patient has remained free of tumor 2 years after surgery. Clinical discussion Clinical and imaging features of SFTs of nasal cavity are not specific. A broad of differential diagnosis is associated with histopathologic features of SFTs. Therefore, immuno-histochemical analyses are crucial to confirm the diagnosis. Complete resection of the mass with clear margins is mandatory to minimize local recurrence. Conclusion SFTs of nasal cavity are very rare neoplasms which continue to pose challenges to practitioner. Pathological examination and mainly immunohistochemical studies are important to establish the diagnosis. Complete resection of the tumor is the key for good outcome. Solitary fibrous tumors of nasal cavity are very uncommon neoplasms. Clinical and imaging features are not specific. Diagnosis is based on immunohistochemical analyses. Malignant behavior cannot be predicted even in the absence of atypical histologic features. Complete resection of the tumor with clear margins and long term surveillance after surgery are mandatory.
Collapse
Affiliation(s)
- Mayssa Khribi
- University of Sousse, Faculty of Medicine of Sousse, ENT Department, Farhat Hached Teaching Hospital, Sousse, Tunisia.
| | - Kermani Wassim
- University of Sousse, Faculty of Medicine of Sousse, ENT Department, Farhat Hached Teaching Hospital, Sousse, Tunisia
| | - Meherzi Abir
- University of Sousse, Faculty of Medicine of Sousse, ENT Department, Farhat Hached Teaching Hospital, Sousse, Tunisia
| | - Badreddine Sriha
- University of Sousse, Faculty of Medicine of Sousse, Anatomopathology Department, Farhat Hached Teaching Hospital, Sousse, Tunisia
| | - Mouna Bellakhdhar
- University of Sousse, Faculty of Medicine of Sousse, ENT Department, Farhat Hached Teaching Hospital, Sousse, Tunisia
| | - Mohamed Abdelkefi
- University of Sousse, Faculty of Medicine of Sousse, ENT Department, Farhat Hached Teaching Hospital, Sousse, Tunisia
| |
Collapse
|
7
|
Parotid Gland Solitary Fibrous Tumor Presenting as a Long Duration Mass: A Case Report. Case Rep Pathol 2022; 2022:2097634. [PMID: 35251728 PMCID: PMC8894058 DOI: 10.1155/2022/2097634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/28/2022] [Indexed: 11/17/2022] Open
Abstract
The solitary fibrous tumor (SFT) is a tumor of uncertain histogenesis, affecting deep soft tissues, particularly the pleura (pulmonary) and extrapulmonary sites including thighs, retroperitoneum, other serosal surfaces, and cranial and spinal meninges. SFT and hemangiopericytoma are now considered the same entity, with general agreement on referring to this group of tumors as “SFT.” SFTs are generally benign tumors with small subsets of malignant ones. Moreover, they are well-circumscribed with a good prognosis after surgical resection. SFTs are uncommon in the head and neck and are quite rare in the parotid gland region. Here, we present a case of a 48-year-old female with SFT of the parotid gland region; the diagnosis was confirmed by positive immunohistochemical staining for Bcl-2, CD34, and STAT6. STAT6 immunohistochemistry is sensitive and specific for SFTs.
Collapse
|
8
|
Lim DWJ, Tan TSH, Tan JL, Venkateswaran K. Solitary fibrous tumour of the parotid gland: a case report and a 15-year literature review. AME Case Rep 2019; 3:14. [PMID: 31231715 DOI: 10.21037/acr.2019.04.05] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 04/12/2019] [Indexed: 11/06/2022]
Abstract
Solitary fibrous tumour (SFT) is uncommonly found in the salivary glands and is a rare group of spindle-cell tumours. A review of literature revealed only 40 reported cases of SFT of major salivary glands over a 15-year period from 2004 to 2018. SFTs of the salivary glands are usually benign, although rarely, can be aggressive and may sometimes recur after initial resection. Histology and Immunohistochemistry are the most important criteria to distinguish SFT from other head and neck tumours. SFTs strongly stain for CD34 and hence is the most frequently used stain for diagnosis. All reported SFT cases with available information on immunohistochemical stains were positive for CD34. Recently, immunohistochemistry for STAT6 has been introduced as a surrogate diagnostic marker for SFT that is highly sensitive and specific. We report a case of a 51-year-old Chinese gentleman who presents with a 3-month history of a left parotid tumour that required a subtotal parotidectomy for complete excision. It was diagnosed as SFT based on histology and immunohistochemical features. He was followed-up for 3 months post-operatively with no clinical evidence of recurrence. This case proposes that, although rare, SFT should be considered in the differential diagnosis of soft-tissue tumors in the major salivary glands. An awareness of this rare entity will help clinicians and pathologists better manage similar patients in the future.
Collapse
Affiliation(s)
| | | | - Jian Li Tan
- Department of Otolaryngology, Khoo Teck Puat Hospital, Singapore
| | | |
Collapse
|
9
|
Shen J, Li H, Feng S, Cui H. Orbital solitary fibrous tumor: a clinicopathologic study from a Chinese tertiary hospital with a literature review. Cancer Manag Res 2018; 10:1069-1078. [PMID: 29780261 PMCID: PMC5951146 DOI: 10.2147/cmar.s165218] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose To report the clinical features, imaging manifestations, histopathology, and immunohistochemical features of several cases of orbital solitary fibrous tumors (SFTs) in a Chinese tertiary hospital, and to undertake a literature review of this rare disease. Methods A non-comparative retrospective review of clinical presentations, imaging manifestations, histopathology, and immunohistochemical features as well as the management and disease outcomes of patients with orbital SFT was conducted along with a review of orbital SFT cases in the literature. Results This study includes two male and two female patients, with an average age of 53 years. Common presentations among these patients included a palpable subcutaneous mass, swelling of the eyelid, proptosis, diplopia, and vision disturbance. Three patients (cases 2–4) underwent imaging scans. All patients had complete surgical excisions and the tissue was subjected to pathological analysis. One patient (Case 4) experienced a recurrence with malignant transformation and received a re-excision surgery and postoperative radiotherapy. All patients remain alive and well after a minimum follow-up of 12 months (range 12–34 months). Conclusion Despite its rare occurrence, we suggest that the possibility of orbital SFTs needs to be considered when a painless, slowly growing orbital mass is identified. Typical characteristic magnetic resonance imaging features of orbital SFTs are iso- or hypointense signals on T1 and T2-weighted images, with marked enhancement. A positive cluster of differentiation 34 (CD34) staining is an important diagnostic clue favoring SFT. Some orbital SFTs are infiltrating, aggressive, or recur with malignant transformation. Therefore, regular long-term follow-up after complete excision is mandatory.
Collapse
Affiliation(s)
| | | | - Shi Feng
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | | |
Collapse
|
10
|
Zielińska-Kaźmierska B, Grodecka J, Szyszkowski A. Solitary fibrous tumor of the nasal cavity and paranasal sinuses: A case report. J Oral Biol Craniofac Res 2015; 5:112-6. [PMID: 26258025 PMCID: PMC4523582 DOI: 10.1016/j.jobcr.2015.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 04/09/2015] [Indexed: 10/23/2022] Open
Abstract
UNLABELLED Solitary Fibrous Tumors (SFT) are rare neoplasms first described in 1931 by Klemperer and Rabin. SFT's have mesenchymal rather than mesothelial origin. They arise mostly from serous membranes, although they also originate in other regions such as: the urogenital system, mediastinal space, lungs, vulva, orbit, thyroid, nasopharyngeal region, larynx, salivary glands. SFT of the nasal cavity and paranasal sinuses are extremely rare. To the year 2014 only 33 cases were reported in English literature. PATIENTS AND METHODS We present a case of 58-year-old man with solitary fibrous tumor localized in the right nasal cavity. The patient presented with an 18-month history of epistaxis and right epiphora. He also reported unilateral right-sided nasal obstruction over the last 6 months. RESULTS CT disclosed a large, homogeneous mass in the nasal cavity infiltrating and destroying nasal septum, turbinates, occupying right maxillary sinus, right ethmoid, extending to the right frontal sinus and right orbit. The infiltration of the right oculus was suspected. Biopsy revealed fibrocytes and histiocytes proliferation with rich vascularization. There was no evidence of histological malignancy. Pathology results were significant for SFT. CONCLUSION The tumor was excised by means of right lateral rhinotomy. Neither the extension to the right maxillary sinus nor the orbital floor infiltration was seen intraoperatively despite the fact, that it was observed in computed tomography before the surgery. The patient had a 5.5-year follow up after surgery, radiological examination showed no recurrence.
Collapse
Affiliation(s)
- Bogna Zielińska-Kaźmierska
- Principal, Department of Cranio-Maxillofacial and Oncological Surgery, Medical University of Lodz, Lodz, Poland
| | - Joanna Grodecka
- Department of Cranio-Maxillofacial and Oncological Surgery, Medical University of Lodz, Lodz, Poland
| | - Adam Szyszkowski
- Resident, Department of Cranio-Maxillofacial and Oncological Surgery, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
11
|
Rai A, Kumar A. Neurofibroma of facial nerve presenting as parotid mass. J Maxillofac Oral Surg 2014; 14:465-8. [PMID: 25848160 DOI: 10.1007/s12663-014-0681-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022] Open
Abstract
Neurogenic neoplasms presenting as parotid gland tumors are extremely uncommon. We present the case of a solitary neurofibroma of the facial nerve within the parotid gland occurring in a 36-year-old male who presented with a painless enlargement in the right-side region of the parotid gland over a period of 1 year with normal facial nerve function. Magnetic resonance imaging revealed a well-demarcated round mass within the right parotid. At surgery, a tumor was found involving the main trunk of the facial nerve, histopathologically representing a neurofibroma.
Collapse
Affiliation(s)
- Arpita Rai
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, 110025 India
| | - Ansul Kumar
- Department of Cardiothoracic Surgery, PGIMER Dr. RML Hospital, New Delhi, India
| |
Collapse
|
12
|
Giant solitary fibrous tumor of the parotid gland. Case Rep Med 2014; 2014:950712. [PMID: 25114687 PMCID: PMC4119921 DOI: 10.1155/2014/950712] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 06/30/2014] [Indexed: 12/02/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are rare tumors that are mostly found arising from the pleura. SFT of the parotid gland is a rare tumor; only a few cases have been described in the literature. SFTs are benign in most cases. Clinically, SFTs usually manifest as well circumscribed, slow-growing, smooth, and painless masses. CT-Scan and MRI are the most sensitive imaging procedures used. The treatment of choice is complete surgical excision of the lesion. Since recurrence and metastasis can take place after several years, a lifelong clinical and imaging regular follow-up is compulsory. In this paper, we describe the diagnostic and therapeutic challenges of the up-to-now biggest parotid SFT. The clinical presentation, surgical management, and pathological and immunohistochemistry findings are described.
Collapse
|
13
|
Alonso-Rodríguez E, González-Otero T, Castro-Calvo A, Ruiz-Bravo E, Burgueño M. Parotid gland solitary fibrous tumor with mandibular bone destruction and aggressive behavior. J Clin Exp Dent 2014; 6:e299-302. [PMID: 25136435 PMCID: PMC4134863 DOI: 10.4317/jced.51256] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 01/19/2014] [Indexed: 11/05/2022] Open
Abstract
Introduction: Solitary fibrous tumor is associated with serosal surfaces. Location in the salivary glands is extremely unusual. Extrathoracic tumors have an excellent prognosis associated with their benign clinical behavior. We report an aggressive and recurrent case of this tumor. We review the clinical presentation, inmunohistochemical profiles and therapeutic approaches.
Case Report: A 73-years-old woman presented a mass in her right parotid gland. She had a past history of right superficial parotidectomy due to a neurilemoma. FNAB and magnetic resonance were non-specific. After a tumor resection, microscopic findings were spindled tumor cells with reactivity to CD34, bcl-2 and CD99 and the tumor was diagnosed as Solitary Fibrous Tumor. The patient suffered two recurrences and the tumor had a histological aggressive behavior and a destruction of the cortical bone of the mandible adjacent to the mass. A marginal mandibulectomy with an alveolar inferior nerve lateralization was performed.
Conclusions: Solitary fibrous tumor is a very rare tumor. Usually, they are benign, but occasionally they can be aggressive. Complete resection is the most important prognostic factor and no evidence supports the efficacy of any therapy different to surgery. Due to the unknown prognosis and to the small number of cases reported, a long-term follow-up is guaranteed.
Key words:Solitary fibrous tumor, parotid mass, parotid gland, salivary gland, rare tumors.
Collapse
Affiliation(s)
| | - Teresa González-Otero
- MD. Department of Oral and Maxillofacial Surgery, Hospital Universitario La Paz, Madrid, Spain
| | | | - Elena Ruiz-Bravo
- MD. Department of Pathology, Hospital Universitario La Paz, Madrid, Spain
| | - Miguel Burgueño
- MD. Department of Oral and Maxillofacial Surgery, Hospital Universitario La Paz, Madrid, Spain
| |
Collapse
|
14
|
Noriko O, Keisuke K, Iwao Y, Keiji Y, Tetsuo H. Solitary fibrous tumor of the head and neck in a child: Case report and review of the literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
15
|
Cristofaro MG, Allegra E, Giudice M. Two New Localizations of Solitary Fibrous Tumor in the Italian Population: Parotid Gland and Oral Cavity—Review of the Literature. J Oral Maxillofac Surg 2012; 70:2360-7. [DOI: 10.1016/j.joms.2011.10.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 10/27/2011] [Accepted: 10/28/2011] [Indexed: 12/16/2022]
|
16
|
Bauer JL, Miklos AZ, Thompson LDR. Parotid gland solitary fibrous tumor: a case report and clinicopathologic review of 22 cases from the literature. Head Neck Pathol 2011; 6:21-31. [PMID: 22002440 PMCID: PMC3311954 DOI: 10.1007/s12105-011-0305-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 09/30/2011] [Indexed: 02/02/2023]
Abstract
Solitary fibrous tumors (SFTs) are rare tumors in the head and neck, and even more so in the parotid gland. The mass-like clinical presentation and histologic features result in frequent misclassification, resulting in inappropriate clinical management. There are only a few reported cases in the English literature. Twenty-one patients with parotid gland solitary fibrous tumor were compiled from the English literature (Medline 1960-2011) and integrated with this case report. The patients included 11 males and 11 females, aged 11-79 years (mean, 51.2 years), who presented with a parotid gland painless mass gradually increasing in size or with compression symptoms, with a mean duration of symptoms of 24.7 months. The mean tumor size was 4.5 cm. Grossly, all tumors were described as well-circumscribed to encapsulated, firm, homogenous white to tan masses. Seven patients had a preoperative fine needle aspiration performed, with the majority interpreted to represent pleomorphic adenoma or cementifying fibroma. Histologically, the tumors were well circumscribed, although many tumors showed focally entrapped normal salivary gland acini and ducts at the edge. The tumors were cellular, arranged in haphazard short interlacing fascicles of spindled to epithelioid cells. The spindled cells showed tapering cytoplasm with monotonous, round to oval nuclei with coarse nuclear chromatin distribution. Keloid-like to wiry collagen was present between the neoplastic cells. Mitoses were identified in most cases, while necrosis was absent. Isolated, patulous vessels were present, but a well developed "hemangiopericytoma-like" vascular pattern was not seen. Three tumors were classified as malignant, showing marked nuclear pleomorphism and increased mitoses. When immunohistochemistry was performed, all tumors showed strong and diffuse vimentin, with a majority showing CD34, bcl-2 and CD99 immunoreactivity; all cases tested were negative for S100 protein, cytokeratin, EMA, CAM5.2, smooth muscle actin, muscle specific actin, desmin, MYOD1, myogenin, CD117, GFAP, CD31, FVIII-RAg, collagen IV, p63, p53, calponin, caldesmon, CD56, NFP, and ALK-1. The principle differential diagnoses include pleomorphic adenoma, myoepithelioma, nodular fasciitis, schwannoma, fibromatosis coli, spindle cell "sarcomatoid" carcinoma, and spindle cell melanoma. All patients were managed with surgery, while two patients also received radiation therapy. Metastatic disease was identified in one patient immediately after excision. All patients with follow-up were alive without evidence of disease (n = 18), but the average follow-up is only 1.9 years. One patient is alive with disease at 12 months. Parotid gland SFT is a rare tumor, usually presenting in middle aged adults as a slowly growing mass. Characteristic histologic appearance with CD34 and bcl-2 immunoreactivity support the diagnosis. Surgery is the treatment of choice to yield a good outcome.
Collapse
Affiliation(s)
- Justin L. Bauer
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91367 USA
| | - Andrew Z. Miklos
- Department of Pathology, The Permanente Medical Group, Roseville, CA USA
| | - Lester D. R. Thompson
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91367 USA
| |
Collapse
|
17
|
Messa-Botero OA, Romero-Rojas AE, Chinchilla Olaya SI, Díaz-Pérez JA, Tapias-Vargas LF. [Primary malignant solitary fibrous tumor/hemangiopericytoma of the parotid gland]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 62:242-5. [PMID: 20684939 DOI: 10.1016/j.otorri.2010.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 02/06/2010] [Accepted: 02/14/2010] [Indexed: 11/17/2022]
Abstract
Solitary fibrous tumor (SFT) was first described in the pleura by Lietaud in 1767; later in 1870, Wagner described the localized nature of this type of tumor and Klemperer and Rabin classified pleural tumors into two types: diffuse mesotheliomas and localized mesotheliomas. Recent years have seen the redefinition of this neoplasm, due to better technology; it is now proven that this neoplasm may have multiple different extrapleural origins including the head and neck regions. This diversity of locations is related to the particular mesenchymal histogenesis of SFT which allows its development from very unusual sites such as the salivary glands (SGs). In this particular site, this neoplasm is very infrequent and most of reported cases refer to benign disease, with just one case informed so far of primary malignant SFT.
Collapse
|
18
|
Wakisaka N, Kondo S, Murono S, Minato H, Furukawa M, Yoshizaki T. A solitary fibrous tumor arising in the parapharyngeal space, with MRI and FDG-PET findings. Auris Nasus Larynx 2008; 36:367-71. [PMID: 18614304 DOI: 10.1016/j.anl.2008.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Revised: 05/27/2008] [Accepted: 05/29/2008] [Indexed: 10/21/2022]
Abstract
We present the imaging and pathological features of a 38-year-old man in whom a large parapharyngeal solitary fibrous tumor (SFT) on the left side was found. On MRI, the tumor showed a nodule-in-nodule appearance. The inner nodule revealed high signal intensities both on T1- and T2-weighted MR images. The entire tumor showed heterogeneous enhancement on gadolinium-enhanced T1-weighted images. (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) identified heterogeneous radiotracer uptake of FDG in the inner nodule of the tumor. Histologic examinations revealed an admixture of growth patterns, including a "patternless pattern" and "haemangiopericytoma-like pattern". The tumor was positive for CD34. Imaging features of SFT arising in the parapharyngeal space are discussed with a review of literatures. This is the first report of FDG-PET finding of SFT arising in the head and neck. More cases are needed to achieve diagnostic significance from FDG-PET findings of parapharyngeal SFTs.
Collapse
Affiliation(s)
- Naohiro Wakisaka
- Department of Otolaryngology, School of Medicine, Kanazawa University, Japan
| | | | | | | | | | | |
Collapse
|
19
|
Kim HJ, Kim HJ, Kim YD, Yim YJ, Kim ST, Jeon P, Kim KH, Byun HS, Song HJ. Solitary fibrous tumor of the orbit: CT and MR imaging findings. AJNR Am J Neuroradiol 2008; 29:857-62. [PMID: 18272558 PMCID: PMC8128581 DOI: 10.3174/ajnr.a0961] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2007] [Accepted: 11/11/2007] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Solitary fibrous tumor (SFT) is a rare spindle-cell neoplasm originating from mesenchymal fibroblast-like cells. The purpose of this study was to describe the CT and MR imaging features of SFTs in the orbit. MATERIALS AND METHODS We retrospectively reviewed CT and MR images in 6 patients (2 men and 4 women), aged 18 to 51 years, with SFT proved on histologic examination located in and around the orbit. All patients underwent CT (including dual-phase CT in 3), and MR imaging was obtained in 3. We evaluated the imaging findings with emphasis on the location, size, margin, internal architecture, and pattern of enhancement of the lesion. RESULTS All 6 lesions were found as a solitary, well-defined mass, ranging in size from 18 to 30 mm (mean, 24 mm). Three were located in the postseptal orbit, 2 in the lacrimal sac, and 1 on the lower eyelid. Compared with the cerebral cortex, all 3 lesions examined by MR imaging showed homogeneous isointense signal intensity on T1-weighted images and heterogeneous mixed isointense and hyperintense signal intensity on T2-weighted images. On visual inspection, all 6 lesions showed marked homogeneous (n = 4) or heterogeneous (n = 2) enhancement on postcontrast CT and MR images. In 3 patients examined with dual-phase CT, all lesions demonstrated rapid enhancement with early washout of contrast material. CONCLUSION SFT might be included in the differential diagnosis of soft tissue masses in the orbit, if one sees a markedly enhancing mass showing the similar characteristics to those of the internal carotid artery on postcontrast CT or MR images.
Collapse
Affiliation(s)
- H J Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
|
21
|
Weon YC, Kim EY, Kim HJ, Byun HS, Park K, Kim JH. Intracranial solitary fibrous tumors: imaging findings in 6 consecutive patients. AJNR Am J Neuroradiol 2007; 28:1466-9. [PMID: 17846192 PMCID: PMC8134371 DOI: 10.3174/ajnr.a0609] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 02/06/2007] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial solitary fibrous tumors (ISFTs) are rare mesenchymal neoplasms originating in the meninges. The aim of this study was to describe the CT, MR imaging, and angiographic features of the solitary fibrous tumor and to identify imaging characteristics. MATERIALS AND METHODS We retrospectively reviewed CT, MR, and angiographic findings in 6 cases of ISFT. We evaluated the size, shape, and location of the tumor; the internal content and margin of the lesion; the pattern of enhancement; and the change of the adjacent structures. Density on noncontrast CT scans, signal intensity on MR images, and angiographic features were also documented. RESULTS Each lesion appeared as a discrete extra-axial mass (size, 3-7 cm; mean, 5 cm). Five lesions were entirely solid, and 1 had peritumoral cyst. All 5 of the noncontrast CT scans showed hyperattenuated masses, and the tumors exhibited marked heterogeneous enhancement. No lesion contained calcification, and 2 cases showed bone invasions. On the MR images, 4 lesions showed mixed signal intensity on T2-weighted imaging. All of the lesions revealed marked heterogeneous enhancement. All of the tumors had thickening of the meninges adjacent to the tumor. Angiography showed delayed tumor blushing in all, and 3 of them had dysplastic dilation of the tumor vessels. CONCLUSION Although there are no pathognomonic imaging findings, some imaging features, such as the "black-and-white mixed" pattern on T2-weighted images and marked heterogeneous enhancement, might be helpful in the diagnosis of intracranial solitary fibrous tumor.
Collapse
Affiliation(s)
- Y C Weon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | | | | | | | | | | |
Collapse
|
22
|
Ridder GJ, Kayser G, Teszler CB, Pfeiffer J. Solitary fibrous tumors in the head and neck: new insights and implications for diagnosis and treatment. Ann Otol Rhinol Laryngol 2007; 116:265-70. [PMID: 17491525 DOI: 10.1177/000348940711600408] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The solitary fibrous tumor (SFT) is a potentially malignant spindle cell neoplasm of mesenchymal origin that was originally described as a thoracic lesion originating from pleural tissue. Recently, numerous extrapleural sites of origin have been described, frequently affecting the head and neck region. The purpose of this article is to focus on a formerly underestimated neoplasm and to highlight its appearance in the head and neck region. METHODS The authors present 2 illustrative cases, including what is probably the first reported case of an SFT arising in the human tonsillar fossa, and give a clinical and pathological literature review. RESULTS The clinical, histologic, and radiologic features are presented, and the surgical treatment is described. The international medical literature concerning SFTs in general and SFTs of the head and neck in particular is reviewed, and the changing concept of SFTs and hemangiopericytomas is discussed on the basis of the updated World Health Organization classification of soft tissue tumors. CONCLUSIONS It is nowadays recognized that the large majority of lesions formerly classified as hemangiopericytomas are, in fact, variants of SFTs. Although still a rare occurrence, SFTs have become increasingly recognized, and clinicians should be aware of their presentation.
Collapse
Affiliation(s)
- Gerd Jürgen Ridder
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical School Freiburg, Germany
| | | | | | | |
Collapse
|
23
|
Ayad T, Ghannoum J. Solitary fibrous tumor with pseudo-lipoblasts involving the sublingual gland: report of a case and review of the literature. Eur Arch Otorhinolaryngol 2006; 264:93-8. [PMID: 16871405 DOI: 10.1007/s00405-006-0119-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Accepted: 06/30/2006] [Indexed: 11/27/2022]
Abstract
Solitary fibrous tumors (SFTs) are mesenchymal neoplasms uncommonly occurring in the salivary glands. In rare instances, SFTs can contain mature fat, atrophic fat, or vacuolated cells previously termed 'pseudo-lipoblasts', which may be misinterpreted as a feature of malignancy. We report an unusual tumor with pseudo-lipoblasts occurring in the sublingual gland. The tumor exhibited a prominent hemangiopericytic pattern, bland cytology, and immunohistochemical and morphologic features consistent with that of an SFT. A review of 15 cases of SFTs of the salivary glands is presented. Emphasis is laid upon the histologic differential diagnosis and the clinical features of these tumors.
Collapse
Affiliation(s)
- Tareck Ayad
- Department of Otolaryngology, Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
| | | |
Collapse
|
24
|
Eloy PH, Nollevaux MC, Watelet JB, Van Damme JP, Collet ST, Bertrand B. Endonasal endoscopic resection of an ethmoidal solitary fibrous tumor. Eur Arch Otorhinolaryngol 2006; 263:833-7. [PMID: 16763824 DOI: 10.1007/s00405-006-0073-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2005] [Accepted: 03/13/2006] [Indexed: 02/06/2023]
Abstract
Solitary fibrous tumor (SFT) is an uncommon spindle cell tumor that typically arises at the level of the pleura in adults. However, SFT has also been reported in various extrapleural sites including orbit, meninges, liver, lung, salivary glands, retroperitoneum, mediastinum. In the head and neck region, SFT has been documented in the external auditory canal, larynx, thyroid, sublingual gland, tongue, parapharyngeal space and the infratemporal fossa. The nose and the paranasal sinuses are a rare site for SFT with only 14 publications in the world literature. We present an additional case of a SFT arising at the level of the right ethmoid sinus successfully removed in one piece endoscopically and review the corresponding literature.
Collapse
Affiliation(s)
- P H Eloy
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital of Mont-Godinne, Université Catholique de Louvain, 5530 Yvoir, Belgium.
| | | | | | | | | | | |
Collapse
|
25
|
Fierek O, Laskawi R, Kunze E. [Solitary intraparotid neurofibroma of the facial nerve. Symptomatology, biology and management]. HNO 2006; 54:772-7. [PMID: 16479387 DOI: 10.1007/s00106-005-1366-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Neurogenic neoplasms of the parotid gland are extremely uncommon. We present the case of a solitary intraparotid neurofibroma of the N. facialis occurring in a 55-year-old female who noted a painless left-side enlargement in the region of the parotid gland over a period of 2 years. Facial function was normal. Magnetic resonance imaging revealed a well-demarcated round mass within the left parotid. At surgery, a tumor was found involving the main trunk of the facial nerve, histopathologically representing a neurofibroma. Since solitary intraparotid neurofibromas are characterized by a very slow growth lacking the propensity for malignant transformation, the tumor was left to preserve facial nerve function. The clinical course over months or even years and the non-specific symptomatology are characteristic of intraparotid facial neurofibromas. Surgical management depends on the clinical setting in the individual case. Conservative treatment based on facial nerve preservation and leaving the tumor in situ is recommended, rather than radical tumor removal with resection of the segment of the N. facialis involved.
Collapse
Affiliation(s)
- O Fierek
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde der Georg-August-Universität Göttingen
| | | | | |
Collapse
|
26
|
Kim HJ, Lee HK, Seo JJ, Kim HJ, Shin JH, Jeong AK, Lee JH, Cho KJ. MR imaging of solitary fibrous tumors in the head and neck. Korean J Radiol 2006; 6:136-42. [PMID: 16145288 PMCID: PMC2685036 DOI: 10.3348/kjr.2005.6.3.136] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective Solitary fibrous tumor (SFT) is a very rare tumor. The purpose of this study is to determine the MR imaging features of SFT in the intracranial and extracranial head and neck regions. Materials and Methods We retrospectively reviewed six MR images and two CT images of six histologically proven cases of SFT that occurred in four men and two women, and their ages ranged from 46 to 59 years. These imaging findings were correlated with the microscopic findings of their surgical specimens. Results Six SFTs arose in the meninges (the petrous ridge and the pituitary fossa), the parotid gland, the parapharyngeal space, the buccal space and the maxillary sinus. On the MR images, SFTs in the intracranial and extracranial head and neck regions were mostly isointense to the muscle on the T1-weighted images, they were hyperintense on the T2-weighted images and they all had intense enhancement. On the T1- and T2-weighted images, hypointense lines were observed within in five SFTs. On the CT images, the SFTs were hypodense to the muscle on the unenhanced images and they were heterogeneously enhanced on the contrast-enhanced images. An exceptional case of pituitary SFT was hypointense on the T2-weighted images and it was hyperdense on the unenhanced CT images, which correlated with the increased collagenous component and the cellular compactness. Conclusion The imaging features of SFT are nonspecific; however, SFT should be included in the differential diagnosis of masses involving the intracranial and extracranial head and neck regions.
Collapse
Affiliation(s)
- Hyun Jeong Kim
- Department of Radiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University, Korea
| | - Ho Kyu Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Jeong Jin Seo
- Department of Radiology, Chonnam National University Medical School, Korea
| | - Hyung Jin Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Ji Hoon Shin
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Ae Kyung Jeong
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Korea
| | - Jeong Hyun Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Kyung Ja Cho
- Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| |
Collapse
|
27
|
Abe T, Murakami A, Inoue T, Ohde S, Yamaguchi T, Watanabe K. Solitary fibrous tumor arising in the sphenoethmoidal recess: a case report and review of the literature. Auris Nasus Larynx 2005; 32:285-9. [PMID: 16054535 DOI: 10.1016/j.anl.2005.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2004] [Revised: 01/20/2005] [Accepted: 01/21/2005] [Indexed: 11/24/2022]
Abstract
Recently, solitary fibrous tumors (SFTs) have been reported in the head and neck area, such as the nasal cavity, thyroid, salivary gland, etc. We present a rare case of SFT which arose from the sphenoethmoidal recess of the nasal cavity, penetrating into the sphenoid sinus, and which showed different intensities on magnetic resonance imaging (MRI) according to the occupied locations. T2 weighted magnetic resonance (MR) images showed low intensity in the nasal cavity, and iso-intensity in the sphenoid sinus. Enhancement with gadolinium contrast on T1-weighted images was more remarkable in the sphenoid sinus than in the nasal cavity. While the tumor in the nasal cavity showed abundant collagen and high cellularity in microscopic examination, numerous small vessels and dilated vascular spaces were remarkable in the tumor of the sphenoid sinus. MRI findings corresponded to pathological findings. We review SFTs in the head and neck area in the English literature.
Collapse
Affiliation(s)
- Tsugio Abe
- Department of Otorhinolaryngology, Koshigaya Hospital, Dokkyo University School of Medicine, 2-1-50 Minamikoshigaya, Koshigaya, Saitama 343-8555, Japan.
| | | | | | | | | | | |
Collapse
|
28
|
Swelam W, Ida-Yonemochi H, Maruyama S, Ikarashi T, Fukuda J, Takagi R, Hayashi T, Saku T. Solitary fibrous tumor of the lower lip involving minor salivary gland components: Report of a case and review of the literature of salivary gland cases. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.ooe.2004.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
29
|
Abstract
Diagnostic imaging of salivary glands has been revolutionized with the advent of cross-sectional imaging modalities like CT and MR imaging. In the era before CT, imaging of the salivary glands was relatively unrewarding and was used uncommonly by ear-nose-throat surgeons. Early diagnostic tests like plain films and sialography evaluated dilated parotid ducts and calculus disease within ducts or glands. Full evaluation of salivary glands, especially deep lobes of parotid gland and masses of minor salivary glands, was not possible by these methods, however. Imaging of the parotid glands has developed significantly since that time. CT and MR imaging greatly compliment physical and endoscopic examinations (and previous favorites like sialography) by direct visualization of previously blind areas of the salivary glands and extension of the disease process in surrounding tissue planes.
Collapse
Affiliation(s)
- Gaurang V Shah
- Department of Radiology, University of Michigan, Room B1G308, 1500 East Medical Center Drive, Ann Arbor, MI 48105, USA
| |
Collapse
|
30
|
Lo CP, Chen CY, Lin CK, Chin SC, Juan CJ, Hsueh CJ. Parasellar Solitary Fibrous Tumor of Meninges: Magnetic Resonance Imaging Features With Pathologic Correlation. J Neuroimaging 2004. [DOI: 10.1111/j.1552-6569.2004.tb00252.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
31
|
Alobid I, Alós L, Maldonado M, Menéndez LM, Bernal-Sprekelsen M. Laryngeal solitary fibrous tumor treated with CO2 laser excision: case report. Eur Arch Otorhinolaryngol 2004; 262:286-8. [PMID: 15170575 DOI: 10.1007/s00405-004-0805-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2003] [Accepted: 03/25/2004] [Indexed: 10/26/2022]
Abstract
The solitary fibrous tumor is an uncommon unilateral benign lesion that usually arises from the pleura. Recently, these tumors have been described in many other locations, such as the mediastinum, head and neck, orbit and urogenital system. To date, only two cases of solitary fibrous tumor arising from the larynx have been reported in the scientific literature. We describe a new case of laryngeal solitary fibrous tumor localized at the right false vocal fold. A 29-year-old man presented with a 6-month history of progressive hoarseness and foreign body sensation in the throat. A mass lesion was recognized in the right false vocal fold, and CT scan demonstrated a large, well-defined tumor without signs of infiltration. The tumor was removed by transoral CO(2) laser surgery. The definitive diagnosis was obtained by immunohistochemical analysis that showed vimentin and CD34-positive cells. The patient remains free of tumor after 15 months of follow-up.
Collapse
Affiliation(s)
- Isam Alobid
- Department of Otorhinolaryngology, Hospital Clínic, C/ Villarroel 170, 08036, Barcelona, Spain.
| | | | | | | | | |
Collapse
|
32
|
Thompson M, Cheng LHH, Stewart J, Marker A, Adlam DM. A paediatric case of a solitary fibrous tumour of the parotid gland. Int J Pediatr Otorhinolaryngol 2004; 68:481-7. [PMID: 15013617 DOI: 10.1016/j.ijporl.2003.10.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2000] [Revised: 10/21/2003] [Accepted: 10/24/2003] [Indexed: 02/07/2023]
Abstract
Solitary fibrous tumours are rare and they were first described in the pleura of the lungs. However this rare tumour is being increasingly recognised in the oro-facial region and other extra-pleural sites among adults. We present a paediatric case of a solitary fibrous tumour of the parotid gland in an 11-year-old girl who was also diagnosed as having type I neurofibromatosis.
Collapse
Affiliation(s)
- M Thompson
- Department of Oral and Maxillofacial Surgery, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 5AZ, UK
| | | | | | | | | |
Collapse
|
33
|
Konstantinidis I, Triaridis S, Triaridis A, Pantzaki A. A rare case of solitary fibrous tumor of the nasal cavity. Auris Nasus Larynx 2003; 30:303-5. [PMID: 12927298 DOI: 10.1016/s0385-8146(03)00064-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Solitary fibrous tumor (SFT) arises in the pleura and less commonly in extrapleural sites. SFT can be found in various head and neck sites. SFTs of the nasal cavity and paranasal sinuses are extremely rare with only ten previously reported cases in the world literature. This case report presents an additional case of SFT of the nasal cavity underlining the benign pattern and the bleeding tendency of nasal SFT, that surgeons managing these tumors should be aware of. Diagnostic procedure, clinical and histopathological findings as well as immunoreactivity of this tumor are discussed, with a review of the current literature.
Collapse
|
34
|
Alobid I, Alós L, Blanch JL, Benítez P, Bernal-Sprekelsen M, Mullol J. Solitary fibrous tumour of the nasal cavity and paranasal sinuses. Acta Otolaryngol 2003; 123:71-4. [PMID: 12625577 DOI: 10.1080/003655402000028052] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Solitary fibrous tumour (SFT) is an uncommon unilateral benign lesion that usually arises from the pleura. Recently, SFT has been described in many other locations, such as the mediastinum, head and neck, orbit and urogenital system. To date, only 21 cases of SFT arising from the nasal cavity and paranasal sinuses have been reported in the literature. MATERIAL AND METHODS We describe a case of SFT localized in the right nasal cavity with extension to the right ethmoid and sphenoid sinuses in a 43-year-old man who presented with a 6-month history of unilateral right-sided nasal obstruction, rhinorrhoea and recurrent epistaxis. RESULTS CT showed a large mass arising from the right anterior ethmoid and sphenoid sinuses. Histopathologically, the lesion consisted of a non-encapsulated mass with spindle-shaped cells within a collagenous stroma. Definitive diagnosis was obtained by means of immunohistochemical analysis, which showed vimentin and CD34 cells. CONCLUSION The tumour was removed by endoscopic sinus surgery, and the patient remained free of tumour after 12 months of follow-up.
Collapse
Affiliation(s)
- Isam Alobid
- Rhinology Unit, Department of Otorhinolaryngology, Hospital Clinic, Barcelona, Spain.
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
In conclusion, if a parotid gland mass is bilateral, it is more likely to be Warthin's tumor, especially if it does not enhance. Less likely, it could be lymphoepithelial cyst or necrotic lymph node. A unilateral, non-enhancing mass with a high T2 signal is more likely to be a Warthin's tumor and less likely a necrotic lymph node or first branchial cleft cyst. If the mass is unilateral, shows postcontrast enhancement, has a high T2 signal, and does not invade surrounding tissue planes, it is more likely to be a pleomorphic adenoma. An intermediate to low T2 signal mass-with or without invasion of surrounding tissue planes--is more likely to be a malignant mass such as adenocystic or mucoepidermoid carcinoma. Biopsy is superior and the gold standard for diagnosis and cannot be replaced by MR imaging, however.
Collapse
Affiliation(s)
- Gaurang V Shah
- Department of Radiology, University of Michigan, Room B1G308, 1500 East Medical Center Drive, Ann Arbor, MI 48105, USA
| |
Collapse
|
36
|
Kumagai M, Suzuki H, Takahashi E, Matsuura K, Furukawa M, Suzuki H, Tezuka F. A case of solitary fibrous tumor of the parotid gland: review of the literatures. TOHOKU J EXP MED 2002; 198:41-6. [PMID: 12498313 DOI: 10.1620/tjem.198.41] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report a rare case of solitary fibrous tumor of the parotid gland. A 47-year-old woman presented with a 3-year-history of left-sided subauricular swelling. Computed tomographic scans and magnetic resonance images revealed a well-defined and dumbbell-shaped mass, measuring about 30 mm in its greatest dimension, in the left parotid gland. Because the tumor occupied both superficial and deep lobes of the gland, she underwent total parotidectomy with preservation of the facial nerve. The microscopic finding showed short-spindle and ovoid cells arranged in a haphazard pattern with interspersed thin collagen fibrils. Immunohistochemically, the tumor cells were strongly positive for CD34, bcl-2 and vimentin, whereas stains for S-100, cytokeratin, smooth muscle actin, collagen type IV and CD117 (KIT) were negative. On the basis of these findings, the tumor was diagnosed as solitary fibrous tumor. Her post-operative course was uneventful, and she is currently free from disease 14 months after surgery. Diagnosis, clinical behavior and treatment of solitary fibrous tumor are reviewed from perusal of the literature.
Collapse
Affiliation(s)
- Masaki Kumagai
- Department of Otolaryngology, Sendai National Hospital, Sendai 983-8520, Japan
| | | | | | | | | | | | | |
Collapse
|
37
|
Guerra MFM, Amat CG, Campo FR, Pérez JS. Solitary fibrous tumor of the parotid gland: a case report. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:78-82. [PMID: 12193898 DOI: 10.1067/moe.2002.121990] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The solitary fibrous tumor is traditionally associated with a mesothelial-lined surface. However, any organ with mesenchymal tissue has the potential for developing this tumor; therefore, it has been described in organs not associated with serosal surfaces. We report a case of solitary fibrous tumor of the parotid gland. Microscopically, the tumor showed a patternless arrangement of spindle cells in a fibrotic background and prominent vascular structures of varying size. Tumor cells showed a strong immunoreactivity for CD34 and bcl-2 antigens, but the tissue was negative for antibodies directed against actins, S-100 protein, and cytokeratins. One year after excision, the patient was alive and without evidence of disease.
Collapse
|
38
|
Gigantelli JW, Kincaid MC, Soparkar CN, Lee AG, Carter SR, Yeatts RP, Holck DE, Hartstein ME, Kennerdell JS. Orbital solitary fibrous tumor: radiographic and histopathologic correlations. Ophthalmic Plast Reconstr Surg 2001; 17:207-14. [PMID: 11388388 DOI: 10.1097/00002341-200105000-00011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To correlate the clinicopathologic and radiographic features characteristic of orbital solitary fibrous tumor (SFT). METHODS The diagnostic features and clinical outcome of seven adults with orbital SFT are retrospectively outlined. Orbital imaging was performed by ultrasonography, computed tomography, or magnetic resonance imaging. Some cases were imaged by multiple modalities. Histopathologic examination of each tumor specimen included standard light and immunohistochemical stains. RESULTS Heterogeneous internal composition was better appreciated on magnetic resonance imaging than on computed tomography. All cases undergoing magnetic resonance imaging showed T1 isointensity and T2 hypointensity relative to gray matter. Strong, generalized immunohistochemical reactivity to vimentin and CD34 validated the diagnosis of SFT and differentiated the specimens from other spindle cell neoplasms. After complete tumor resection, our patients remain tumor free with postoperative intervals of 15 to 45 months. CONCLUSIONS Solitary fibrous tumor has now been reported in 26 orbits. No physical finding is pathognomonic, but several imaging traits are highly characteristic. Intralesional image heterogeneity and a predominantly low T2 signal intensity are distinctive of SFT. Complete tumor resection and immunohistologic specimen evaluation are emphasized. Clinicians should consider the diagnosis of SFT when confronted with an adult patient having an orbital soft tissue mass demonstrating the distinctive magnetic resonance imaging findings.
Collapse
Affiliation(s)
- J W Gigantelli
- Department of Ophthalmology, University of Missouri-Columbia, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Talacko AA, Aldred MJ, Sheldon WR, Richard Hing N. Solitary fibrous tumour of the oral cavity: report of two cases. Pathology 2001. [DOI: 10.1080/00313020126298] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
40
|
Ide F, Shimoyama T, Horie N, Tanaka H. Collagenous fibroma (desmoplastic fibroblastoma) presenting as a parotid mass. J Oral Pathol Med 1999; 28:465-8. [PMID: 10551744 DOI: 10.1111/j.1600-0714.1999.tb02107.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe the case of a 50-year-old man who was found to have a painless, slow-growing parotid mass of 10 months duration. At surgery, a well-delimited, lobulated 4x5-cm tumor was located on the deep lobe of the left parotid gland, adhering to the parotid sheath and masseteric fascia. Follow-up 6 years later has shown no evidence of recurrence. Cardinal morphologic features included multiple nodules of sparsely distributed stellate-or spindle-shaped fibroblasts within a collagenous or myxocollagenous stroma. Fascial involvement and entrapment of salivary gland were focally identified at the edges. Tumor cells were diffusely positive for vimentin with faint focal staining for alpha-smooth muscle actin. These findings satisfied the diagnostic criteria for collagenous fibroma (desmoplastic fibroblastoma). Ours represents the first report of this tumor type mimicking a parotid tumor.
Collapse
Affiliation(s)
- F Ide
- Department of Oral Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan
| | | | | | | |
Collapse
|