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Solitary fibrous tumors of the head and neck: a clinicopathologic and radiologic review
- Source :
- Archives of otolaryngology--headneck surgery. 132(5)
- Publication Year :
- 2006
-
Abstract
- Objective To describe the clinicopathologic and radiologic features of solitary fibrous tumors of the head and neck. Design Retrospective analysis. Setting Tertiary referral center that performs head and neck surgical oncology. Patients Twelve patients with solitary fibrous tumors of the head and neck identified from the pathology and soft tissue tumor databases at Memorial Sloan-Kettering Cancer Center, New York, NY, from 1990 to 2004. All cases were reviewed by 3 experienced pathologists, 1 of whom is an experienced soft tissue tumor pathologist. The diagnosis was confirmed by microscopic features on hematoxylin-eosin staining and by positive staining for CD34 and Bcl2 on immunohistochemical analysis. Tumors were scored for mitotic activity, cellularity, nuclear pleomorphism, necrosis, and the presence of a malignant component. Details on patient characteristics, tumor characteristics, previous treatment and surgery, adjuvant treatment, and outcome were recorded from clinical records. Results Solitary fibrous tumors occurred in patients over a wide age range (27-78 years; median age, 52 years). Seven patients (58%) were women, and 5 (42%) were men. Most tumors presented as a slow-growing painless mass with a duration ranging from 2 months to 5 years. The tumors ranged from 1 × 1 cm to 6 × 5 cm. Patients presented with a subcutaneous mass of the scalp or face in 4 cases, intraoral mass in 4, sinonasal mass in 3, and paraspinal mass in 1. Computed tomographic and/or magnetic resonance imaging scans of 7 of the 12 patients showed well-circumscribed tumors that enhanced strongly with contrast. Treatment for all of the patients was surgical resection. Pathologic findings showed that 9 tumors were benign and 3 were malignant. Three patients had a positive surgical resection margin. All patients were alive at a median follow-up of 8 months (range, 1-76 months). Local recurrence occurred in 1 patient who had positive surgical margins 3 years after the initial surgery. Conclusions Solitary fibrous tumors of the head and neck region are rare and most commonly benign. The diagnosis depends on microscopic and immunohistochemical features, although imaging may help. Patients with these tumors can be safely treated with local excision, but tumors with positive margins require close follow-up over several years owing to the potential for late local recurrence.
- Subjects :
- Adult
Male
medicine.medical_specialty
Solitary fibrous tumor
Soft Tissue Neoplasm
Neoplasms, Fibrous Tissue
Mitosis
Antigens, CD34
Soft Tissue Neoplasms
12E7 Antigen
Diagnosis, Differential
Subcutaneous Tissue
Surgical oncology
Antigens, CD
medicine
Biomarkers, Tumor
Humans
Survival rate
Aged
business.industry
Soft tissue
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Surgery
Survival Rate
Otorhinolaryngologic Neoplasms
Otorhinolaryngology
Proto-Oncogene Proteins c-bcl-2
Disease Progression
Histopathology
Female
Radiology
Differential diagnosis
Positive Surgical Margin
business
Tomography, X-Ray Computed
Cell Adhesion Molecules
Follow-Up Studies
Subjects
Details
- ISSN :
- 08864470
- Volume :
- 132
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Archives of otolaryngology--headneck surgery
- Accession number :
- edsair.doi.dedup.....bda30d1aae9ee7f92474e8cbbba03a10