Solitary fibrous tumor of the paranasal sinus, a case report

Introduction:

Solitary fibrous tumors (also called hemangiopericytoma) are with about 0.6% to a rare mostly benign subgroup of soft tissue tumors. They are mainly known in the thoracic region (pleura), but have also been described in various other localizations.

Case report:

We report a 36-year-old female patient who was being treated in our clinic due to a traumatic orbital floor fracture. In the CT scan, there was a mass in the area of the ethmoid bone and right frontal sinus with partial destruction of the lamina papyracea and protrusion after intraorbital by 5 mm. Histopathological workup revealed spindle-cell mesenchymal tissue with elongated fibroblastoid cells. Immunohistochemical antibodies to vimentin and BCL-2 were strong and moderately detectable against S100, CD99 and CD34. Malignancy criteria were not met. After receiving the histology, the endoscopic resection of the findings was done in toto.

As a secondary finding, a definable finding with a homogeneous contrast agent recording of approx. 12 × 11 × 17 mm was noticeable in the medial arch of HWK 1. A partial resection of the atlas by our colleagues in neurosurgery then revealed a tenosynovial giant cell tumor. The suspicion of metastasis of the SFT could thus be ruled out.

Semi-annual clinical and cMRT controls have not shown any recurrence at the 2 or 3 year follow-up.

Discussion:

Solitary fibrous tumors may be considered in the differential diagnosis of a paranasal sinus tumor and should be completely resected to prevent recurrence. The combination of a CT scan, histological findings and immunohistochemical staining ensures the diagnosis. Despite its generally benign nature (intermediate malignancy), malignant transformation and metastasis ( < 2%) must be considered in very rare cases.

Holger Mehlhorn

Städtisches Klinikum Dessau,

Prager Straße 14B, 04103

Leipzig

Email: [e-mail]

Publication History

Publication Date:
23 April 2019 (online)