Mohd Fauzi Nurul Anis, Ibrahim Noor Idayu, Wan Abdul Rahman Wan Faiziah, Tuan Sharif Sharifah Emilia, Abu Bakar Muhammad Nasri, Ramli Ramiza Ramza
Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
Ann Med Surg (Lond). 2021 Nov 10;72:103032. doi: 10.1016/j.amsu.2021.103032. eCollection 2021 Dec.
A solitary fibrous tumour (SFT) is a rare neoplasm that commonly arises in the pleura and can occur in other extrathoracic sites. Extrapleural SFT, particularly in the sinonasal cavity, is extremely rare. There are no definite diagnostic criteria for sinonasal SFT as it is rare. Histologic analysis with immunohistochemistry plays an important role in diagnosing SFT.
We report herein a case of SFT of the sinonasal cavity, which later spread to the oral cavity in a 67-year-old male with underlying papillary thyroid carcinoma (PTC) stage IV. He complained of recurrent epistaxis from a mass in his left nasal cavity for two weeks. The mass grew bigger, and spread to the oral cavity, causing dysphagia and upper airway obstruction. Tracheostomy was done under local anaesthesia and a biopsy of the mass was taken to rule out metastasis from the PTC. However, histopathological examination revealed a mesenchymal tumour of fibroblastic type, consistent with an SFT. He was planned for surgical resection of the tumour. However, he refused the operation and was lost to follow-up.
We describe the clinical presentation of this rare tumour of the sinonasal and oral cavity, including upper airway obstruction, and the importance of immunohistochemical markers such as CD34 and BCL-2 in diagnosing SFT. Complete resection of the tumour is the definitive treatment for SFT.
SFT of the sinonasal and oral cavity is extremely rare. Upper airway obstruction may occur due to the location of the tumour in the airway region. Immunohistochemistry is crucial to distinguish this tumour from other mesenchymal tumours.
孤立性纤维瘤（SFT）是一种罕见的肿瘤，通常起源于胸膜，也可发生于其他胸外部位。胸膜外SFT，尤其是发生在鼻窦腔的，极为罕见。由于鼻窦SFT罕见，尚无明确的诊断标准。组织学分析及免疫组化在SFT的诊断中起着重要作用。
我们在此报告一例鼻窦腔SFT病例，该病例发生在一名67岁患有IV期甲状腺乳头状癌（PTC）的男性患者身上，后来肿瘤扩散至口腔。他因左侧鼻腔肿物反复鼻出血两周前来就诊。肿物逐渐增大并扩散至口腔，导致吞咽困难和上呼吸道梗阻。在局部麻醉下行气管切开术，并对肿物进行活检以排除PTC转移。然而，组织病理学检查显示为成纤维细胞型间叶组织肿瘤，符合SFT。计划对其进行肿瘤手术切除。但他拒绝手术并失访。
我们描述了这种鼻窦和口腔罕见肿瘤的临床表现，包括上呼吸道梗阻，以及免疫组化标志物如CD34和BCL-2在诊断SFT中的重要性。肿瘤的完整切除是SFT的确定性治疗方法。
鼻窦和口腔的SFT极为罕见。由于肿瘤位于气道区域，可能会发生上呼吸道梗阻。免疫组化对于将该肿瘤与其他间叶组织肿瘤区分开来至关重要。
