Sinonasal Solitary Fibrous Tumor: a rare entity
DOI:
https://doi.org/10.34631/sporl.921Keywords:
Solitary fibrous tumoR, Nasal Cavity, Paranasal Sinuses, Endoscopic sinus surgeryAbstract
Solitary Fibrous Tumors (SFT) are spindle-cell mesenchymal neoplasms mostly described in pleura. Sinonasal SFT are rare, with less than 100 cases reported in literature. We present a case of a 70-year-old female patient with a posterior ethmoidal solitary fibrous tumor occupying the posterior nasal cavity. The patient presented with a 8-month history of unilateral nasal obstruction and epistaxis. Anterior rhinoscopy evidenced a smooth and friable mass, partially obliterating the left choana. CT and MRI revealed a well-circumscribed enhancing mass with no osseous invasion. The tumor was completely removed by endoscopic sinus surgery. Histopathological examination revealed a spindle cell tumor, with a patternless arrangement, within a collagenous stroma, highly vascularized. The tumor cells strongly stained for CD34 and Vimentin, and were negative for epithelial, vascular, neural crest and muscular markers. After 2 years of follow up, the patient remains asymptomatic with no evidence of recurrence.
References
Klemperer P, Coleman BR. Primary neoplasms of the pleura. A report of five cases. Am J Ind Med 1992;22(1):1-31. doi: 10.1002/ajim.4700220103
Janjua A, Sklar M, Macmillan C, Vescan A. et al. Endoscopic resection of solitary fibrous tumors of the nose and paranasal sinuses. Skull Base. 2011 Mar;21(2):129-34. doi: 10.1055/s-0031-1275259.
Stanisce L, Ahmad N, Levin K, Deckard N. et al. Solitary Fibrous Tumors in the Head and Neck: Comprehensive Review and Analysis. Head Neck Pathol. 2020 Jun;14(2):516-524. doi: 10.1007/s12105-019-01058-6.
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. May-Aug 2015;5(2):112-6. doi: 10.1016/j.jobcr.2015.04.001.
Kakkar A, Sakthivel P, Rajeshwari M, Kairo A. et al. Recurrent Sinonasal CD34-Negative Malignant Solitary Fibrous Tumor Diagnosed on STAT6 Immunohistochemistry and NAB2-STAT6 Fusion. Head Neck Pathol. 2020 Mar;14(1):250-256. doi: 10.1007/s12105-018-00999-8.
Papadakis I, Koudounarakis E, Haniotis V, Karatzanis A. et al. Atypical solitary fibrous tumor of the nose and maxillary sinus. Head Neck. 2013 Mar;35(3):E77-9. doi: 10.1002/hed.21909.
Rizzo S, Giunta AA, Pennacchi A. Sinonasal and rhinopharyngeal solitary fibrous tumour: a case report and review of the literature. Acta Otorhinolaryngol Ital. 2015 Dec;35(6):455-8. doi: 10.14639/0392-100X-163813.
Tatekawa H, Shimono T, Ohsawa M, Doishita S. et al. Imaging features of benign mass lesions in the nasal cavity and paranasal sinuses according to the 2017 WHO classification. Jpn J Radiol. 2018 Jun;36(6):361-381. doi: 10.1007/s11604-018-0739-y.
Thompson LDR, Lau SK. Sinonasal Tract Solitary Fibrous Tumor: A Clinicopathologic Study of Six Cases with a Comprehensive Review of the Literature. Head Neck Pathol. 2018 Dec;12(4):471-480. doi: 10.1007/s12105-017-0878-y.
Koeller KK. Radiologic Features of Sinonasal Tumors. Head Neck Pathol. 2016 Mar;10(1):1-12. doi: 10.1007/s12105-016-0686-9.
Yang BT, Song ZL, Wang YZ, Dong JY. et al. Solitary fibrous tumor of the sinonasal cavity: CT and MR imaging findings. AJNR Am J Neuroradiol. Jun-Jul 2013;34(6):1248-51. doi: 10.3174/ajnr.A3485.
Daigeler A, Lehnhardt M, Langer S, Steinstraesser L. et al. Clinicopathological findings in a case series of extrathoracic solitary fibrous tumors of soft tissues. BMC Surg. 2006 Jul 6;6:10. doi: 10.1186/1471-2482-6-10.
Takasaki K, Watanabe T, Hayashi T, Kinoshita N. et al. Solitary fibrous tumor arising from the sphenoid sinus. Case Rep Med. 2009;2009:316042. doi: 10.1155/2009/316042.
Cox DP, Daniels T, Jordan RC. Solitary fibrous tumor of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jul;110(1):79-84. doi: 10.1016/j.tripleo.2010.01.023.
Zeitler DM, Kanowitz SJ, Har-El G. Malignant solitary fibrous tumor of the nasal cavity. Skull Base. 2007 Jul;17(4):239-46. doi: 10.1055/s-2007-984489.
Kim HJ, Lee HK, Seo JJ, Kim HJ. et al. MR imaging of solitary fibrous tumors in the head and neck. Korean J Radiol. Jul-Sep 2005;6(3):136-42. doi: 10.3348/kjr.2005.6.3.136.
Jiang K, Li S, Cheng L, Yang J. et al. Intratympanic methylprednisolone administration promotes the recovery of idiopathic sudden sensorineural hearing loss: a retrospective case-control study. Acta Otolaryngol. 2018 Nov;138(11):998-1003. doi: 10.1080/00016489.2018.1504170.
Thway K, Ng W, Noujaim J, Jones RL. et al. The Current Status of Solitary Fibrous Tumor: Diagnostic Features, Variants, and Genetics. Int J Surg Pathol. 2016 Jun;24(4):281-92. doi: 10.1177/1066896915627485.
Eloy PH, Nollevaux MC, Watelet JB, Van Damme JP. et al. Endonasal endoscopic resection of an ethmoidal solitary fibrous tumor. Eur Arch Otorhinolaryngol. 2006 Sep;263(9):833-7. doi: 10.1007/s00405-006-0073-3.
Witkin GB, Rosai J. Solitary fibrous tumor of the upper respiratory tract. A report of six cases. Am J Surg Pathol. 1991 Sep;15(9):842-8. doi: 10.1097/00000478-199109000-00004.
Geramizadeh B, Marzban M, Churg A. Role of Immunohistochemistry in the Diagnosis of Solitary Fibrous Tumor, a Review. Iran J Pathol. Summer 2016;11(3):195-203.
Vogels RJ, Vlenterie M, Versleijen-Jonkers YM, Ruijter E. et al. Solitary fibrous tumor - clinicopathologic, immunohistochemical and molecular analysis of 28 cases. Diagn Pathol. 2014 Nov 29;9:224. doi: 10.1186/s13000-014-0224-6.
Davanzo B, Emerson RE, Lisy M, Koniaris LG. et al. Solitary fibrous tumor. Transl Gastroenterol Hepatol. 2018 Nov 21;3:94. doi: 10.21037/tgh.2018.11.02.
Doyle LA, Vivero M, Fletcher CD, Mertens F. et al. Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics. Mod Pathol. 2014 Mar;27(3):390-5. doi: 10.1038/modpathol.2013.164.
Demicco EG, Park MS, Araujo DM, Fox PS. et al. Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model. Mod Pathol. 2012 Sep;25(9):1298-306. doi: 10.1038/modpathol.2012.83.
Koelsche C, Schweizer L, Renner M, Warth A. et al. Nuclear relocation of STAT6 reliably predicts NAB2-STAT6 fusion for the diagnosis of solitary fibrous tumour. Histopathology. 2014 Nov;65(5):613-22. doi: 10.1111/his.12431.
Ganly I, Patel SG, Stambuk HE, Coleman M. et al. Solitary fibrous tumors of the head and neck: a clinicopathologic and radiologic review. Arch Otolaryngol Head Neck Surg. 2006 May;132(5):517-25. doi: 10.1001/archotol.132.5.517.
Kayani B, Sharma A, Sewell MD, Platinum J. et al. A Review of the Surgical Management of Extrathoracic Solitary Fibrous Tumors. Am J Clin Oncol. 2018 Jul;41(7):687-694. doi: 10.1097/COC.0000000000000348.
Pasquini E, Cantaroni C, Salfi N, Tamburini G. et al. Endoscopic treatment of an ethmoidal solitary fibrous tumour. J Laryngol Otol. 2003 Nov;117(11):889-91. doi: 10.1258/002221503322542926.
Yammine K, Nasser HA, Hadi U, Natout MA. et al. Salvage preoperative embolization of an infratemporal solitary fibrous tumor: A case report with review of the literature. Medicine (Baltimore). 2018 Mar;97(13):e0251. doi: 10.1097/MD.0000000000010251.
Pasquali S, Gronchi A, Strauss D, Bonvalot S. et al. Resectable extra-pleural and extra-meningeal solitary fibrous tumours: A multi-centre prognostic study. Eur J Surg Oncol. 2016 Jul;42(7):1064-70. doi: 10.1016/j.ejso.2016.01.023.
Gold JS, Antonescu CR, Hajdu C, Ferrone CR. et al. Clinicopathologic correlates of solitary fibrous tumors. Cancer. 2002 Feb 15;94(4):1057-68. doi.org/10.1002/cncr.10328.
Martínez V, Jiménez ML, Cuatrecasas M, Jürgens A. et al. [Solitary naso-sinusal fibrous tumor]. Acta Otorrinolaringol Esp. Jul-Aug 1995;46(4):323-6.
Smith SC, Gooding WE, Elkins M, Patel RM. et al. Solitary Fibrous Tumors of the Head and Neck: A Multi-Institutional Clinicopathologic Study. Am J Surg Pathol. 2017 Dec;41(12):1642-1656. doi: 10.1097/PAS.0000000000000940.
Jo VY, Fletcher CD. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology. 2014 Feb;46(2):95-104. doi: 10.1097/PAT.0000000000000050.
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