Abstract
Background Solitary fibrous tumours are rare. The aim of this study is to describe the clinical
features, therapy and outcome of affected patients and to identify factors associated
with recurrence.
Methods Retrospective study of a cohort of 20 patients who underwent surgery for orbital
solitary fibrous tumour at the University Department of Oral and Maxillofacial Surgery
between 2002 and 2023. Demographic, clinical, and therapeutic data as well as tumour
follow-up results were collected. Tumour volume and molecular genetic mutations were
retrospectively determined.
Results The median patient age was 49.5 years at initial surgery. The left orbit was affected
in 65% of cases. The most common clinical symptom was proptosis (80%). This was reported
with a mean lateral difference of 3.9 mm (range: 1 – 10 mm). The tumours were localised
predominantly in the intra- and extraconal space, craniolateral quadrant and middle
third. The median tumour volume was 7.66 cm³ (range 2.15 – 12.57 cm³). In all patients,
the diagnosis was made by pathological examination. All tumours investigated showed
a NAB2-STAT6 mutation. The most frequently detected mutation was the fusion NAB2 exon
4 – STAT6 exon 2. All patients were initially managed with frontolateral orbitotomy.
Incomplete resection (R1-status) occurred in 35% (n = 7). The recurrence rate was
25% (n = 5), with a median disease-free interval of 45.5 months (range 23 – 130).
80% (n = 4) of recurrences were initially R1-resected.
Conclusion Orbital solitary fibrous tumours are rare tumours and are clinically manifested by
signs of displacement of orbital structures. Diagnosis is made by histology and immunohistochemistry
and can be proven with the molecular genetic detection of the NAB2-STAT6 mutation.
The therapy of choice is complete surgical resection. R1-resection is more likely
in the intraconal location as well as in location in the posterior third of the orbit
– due to difficult surgical accessibility. The greatest risk factor for the development
of recurrence is incomplete surgical excision. Late recurrences are possible, which
is why a long-term connection to a specialised clinic is necessary.
Key words
solitary fibrous tumours - orbital neoplasia - frontolateral orbitotomy - retrospective
study - nab2-stat6 mutation - recurrence risk factors
