Tariq Muhammad Usman, Alsulaiman Abdullah, Kashif Ammara, Keshk Eman, Alhassani Salwa H, Alkhudaidi Hessa
Histopathology Unit, Laboratory Department, Al Hada Armed Forces Hospital, Taif, SAU.
Laboratory Department, Al Hada Armed Forces Hospital, Taif, SAU.
Cureus. 2024 Apr 13;16(4):e58213. doi: 10.7759/cureus.58213. eCollection 2024 Apr.
Solitary fibrous tumors (SFTs) uncommonly involve the head and neck region. Head and neck SFTs (HNSFTs) exhibit diverse histological features and can mimic several neoplasms with different treatment and behavior. Herein, we report the clinicopathological features of three cases of HNSFT. Case 1 was a 29-year-old female who presented with a nasal cavity mass measuring 3.5 cm. The patient underwent surgical excision. Microscopic examination revealed classic histological and immunohistochemical (IHC) features of SFT. Unusual histological features included epithelioid morphology, clear cells, and edematous change. She developed local recurrence after 11 months, which was also treated with surgery. Case 2 was a 55-year-old male who developed a 1-cm mass at the buccal mucosa. Surgical excision of the tumor was performed. The tumor was completely circumscribed microscopically. Characteristic histological and IHC features of SFT were identified. Unusual histological features observed were an adenomatous pattern, clear cells, and myxoid change. The patient was alive and disease-free at the 12-month follow-up. Case 3 was a 59-year-old female presenting with a medial canthus mass measuring 1.4 cm. The patient underwent surgical excision. Histological and IHC features observed were diagnostic for SFT. Unusual histological features identified were wavy nuclei and multinucleated stromal giant cells. The patient was alive and disease-free at the 124-month follow-up. Diagnosis of SFT can be challenging in unusual locations like the head and neck region. In addition, the histological spectrum of HNSFT is diverse. Therefore, knowledge about unusual histological features and classic IHC expression is essential for establishing correct diagnosis. Long-term follow-up is recommended because of the risk of recurrence in HNSFT.
孤立性纤维瘤(SFTs)很少累及头颈部区域。头颈部SFTs(HNSFTs)表现出多样的组织学特征,可模仿几种具有不同治疗方法和行为的肿瘤。在此,我们报告3例HNSFT的临床病理特征。病例1为一名29岁女性,出现一个3.5 cm的鼻腔肿物。患者接受了手术切除。显微镜检查显示SFT的典型组织学和免疫组化(IHC)特征。不寻常的组织学特征包括上皮样形态、透明细胞和水肿改变。11个月后她出现局部复发,也接受了手术治疗。病例2为一名55岁男性,在颊黏膜出现一个1 cm的肿物。对肿瘤进行了手术切除。肿瘤在显微镜下完全被包膜包裹。识别出SFT的特征性组织学和IHC特征。观察到的不寻常组织学特征为腺瘤样模式、透明细胞和黏液样改变。在12个月的随访中,患者存活且无疾病。病例3为一名59岁女性,出现一个1.4 cm的内眦肿物。患者接受了手术切除。观察到的组织学和IHC特征可诊断为SFT。识别出的不寻常组织学特征为波浪状核和多核间质巨细胞。在124个月的随访中,患者存活且无疾病。在头颈部这样的不寻常部位,SFT的诊断可能具有挑战性。此外,HNSFT的组织学谱是多样的。因此,了解不寻常的组织学特征和经典的IHC表达对于确立正确诊断至关重要。由于HNSFT有复发风险,建议进行长期随访。