Oral Solitary Fibrous Tumor: A Retrospective Clinico-Pathological Study and Long-Term Follow-Up

Oral solitary fibrous tumors: A collaborative clinicopathologic study of 19 cases

OBJECTIVE

To report the clinicopathologic features of 19 oral solitary fibrous tumors (SFTs).

METHODS

Clinical data were collected from the records of seven pathology services. All cases were re-evaluated by HE staining and confirmed by immunohistochemistry.

RESULTS

The series comprised 11 females (57.9%) and 8 males (42.1%), with a mean age of 47.3 ± 14.7 years (range: 22-71 years) and a 1.3:1 female-to-male ratio. Most tumors affected the buccal mucosa (n = 7; 36.8%) and presented clinically as an asymptomatic solitary submucosal well-circumscribed nodule with coloration similar to the oral mucosa. Morphologically, most SFTs (n = 10; 52.6%) exhibited a classic hybrid pattern characterized by a well-circumscribed proliferation of densely cellular areas alternating with hypocellular areas in a variably collagenous vascular stroma. Remnants of accessory salivary glands were observed in two cases (n = 2; 10.5%). All tumors were positive for STAT6 and CD34 (n = 19; 100%). Outcome information was available from 6 patients (31.6%), with clinical follow-up ranging from 6 to 24 months (mean ± SD, 9.5 ± 6.8 months), and none developed local recurrence.

CONCLUSIONS

Oral SFTs are rare and often clinically misdiagnosed. Pathologists should consider SFT in the differential diagnosis of oral spindle cell tumors. Accurate diagnosis requires careful morphological evaluation supported by immunohistochemical analysis.

Buccal cheek mucosa solitary fibrous tumor. Case report

Solitary fibrous tumor (STF) is a mesenchymal tumor that mainly appears in the pleura. Its presence in the oral cavity is very uncommon, being the buccal mucosa the most frequent location. Imaging cannot distinguish this entity between other types of tumors, being histological and immunohistochemical studies essential for its diagnosis. Immunohistochemical stains typically show positive results for CD34, Bcl2, and CD99. Surgical removal with wide margins is the gold standard treatment, requiring a close follow up due to recurrence risk. We present a case report of a solitary fibrous tumor located in the buccal cheek mucosa and the surgical approach. Key words:Solitary fibrous tumor, Buccal mucosa, Intraoral, Immunohistochemical markers.

A multicentric case study of fibroblastic and myofibroblastic oral spindle cell lesions

Context

Spindle cell lesions comprise a vast plethora of benign and malignant lesions with similar clinical and radiographic features. Their overlapping histopathologic features ensure a diagnostic dilemma.

Aim

The current multicentric study aims to delineate fibroblastic and myofibroblastic oral spindle cell lesions based on cytomorphology and comprehensive immunohistochemical analysis.

Settings and Design

The experimental study was conducted at MS Ramaiah University of Applied Sciences, Bangalore, and All India Institute of Applied Sciences, Delhi.

Methods and Material

A comprehensive histological scoring criteria and panel of immunohistochemical makers (STAT6, CD31, CD34, S100, SMA, vimentin, pan-CK, HHF-35, Ki67, ALK, desmin, HMB-45, SATB2, ERG, EMA and CD99) were employed concurrently for the first time for fibroblastic and myofibroblastic oral spindle cell lesions. The data obtained was tabulated and studied.

Statistical Analysis Used

NA. Results: Using cytological scoring criteria and panel of immunohistochemical makers, the cases analysed and characterized were desmoplastic fibroma, fibrosarcoma, leiomyosarcoma, nodular fasciitis, neurofibroma and epithelioid inflammatory myofibroblastic sarcoma (EIMS).

Conclusions

The diagnostic strategies need to be upgraded for the diagnosis of spindle cell lesions. Emphasis must be placed on cytomorphology, an immunohistochemistry (IHC) panel of markers is imperative for the accurate diagnosis of fibroblastic and myofibroblastic oral spindle cell lesions.

Orbital solitary fibrous tumours: clinicopathological characteristics and recurrence prediction

BACKGROUND

SFTs are thought to have an unpredictable clinical course and currently have no recognized prognostic criterion. Our study aimed to determine the relationship between clinicopathological characteristics and the prognosis of patients with orbital SFTs.

METHODS

The clinicopathological features of these patients were extracted from clinical records. The relationships between these features and prognosis were analysed.

RESULTS

The positive rates of CD34, CD99, Blc2, and STAT6 expression were 90.3%, 90.3%, 83.9%, and 100%, respectively. The tumour recurrence rate was 38.7%. A higher recurrence rate was observed in patients with Ki67 index ≥ 5 (56.25% vs. 20%, P = 0.038).

CONCLUSION

A Ki67 index ≥ 5 was an effective parameter for predicting tumour recurrence of orbital SFTs. Close follow-up is needed for these patients.

Solitary Fibrous Tumor of Hard Palate: A Case Report and Literature Review

Solitary fibrous tumor (SFT) is a mesenchymal tumor accounting for less than 2% of soft tissue tumors and has variable clinical behavior. It can arise in many anatomical locations of the body and in rare occasions in the oral cavity mostly in buccal mucosa and tongue. To date, a handful of such cases have been reported in the hard palate. We present a case of SFT in the hard palate of a 32-year-old man and describe the tissue morphology, immunohistochemistry workup, and follow-up together with literature review.

Solitary fibrous tumor of the tongue

Solitary fibrous tumor (SFT) is a benign mesenchymal neoplasm originally described in pleura with a rare presentation in the oral cavity. Herein, we report a case of a 28-year-old male patient who presented an asymptomatic slow-growing mass in the anterior part of the tongue. Intraoral examination revealed a well-circumscribed mass covered by normal mucosa with a fibrous consistency. Due to non-specific clinical findings, the initial diagnostic hypotheses include benign submucosal neoplasms such as leiomyoma, neurofibroma, SFT, and others. An excisional biopsy was performed. Microscopically, the tumor was surrounded by a thick fibrous capsule; hypo and hypercellular areas were arranged in a storiform pattern with a stroma formed by collagen and abundant vascularization. Tumor cells showed immunopositivity for CD34 and STAT-6 and no expression of CD99, AML, S-100, and Ki-67. According to these findings, the diagnosis of SFT was established. After 24 months, the patient is asymptomatic and has no evidence of recurrence. Although oral involvement is rare, SFT should be included in the differential diagnosis of oral submucosal lesions.