Paralaryngeal solitary fibrous tumor - an extremely rare neoplasm

Introduction Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms of mesenchymal origin arising in the majority of the cases from the pleura. Extrapleural forms are much more rare. In literature almost 6 % of the SFTs are located in the head and neck. Most present as a slow-growing painless mass with benign behavior.

Case report We present a case of a 52 year old woman with an asymptomatic, slowly enlarging, solitary palpable neck mass on the right side. The laryngoscopy revealed a round submucosal mass arising from the posterior wall of the hypopharynx and causing partial obstruction of the lumen. MRI showed a well defined, enhancing lesion in the right cervical space with contact to to the larynx and compression of the hypopharynx measuring 4.0 x 2.0 x 1.5cm.

The well subscribed mass was totally excised via a right transcervical approach. The mass was located medial the great vessels an the nervus laryngeus superior with extensive contact to the thyrohyoid membrane and expansion in the hypopharynx.

The histological examination of the lesion revealed an extrapleural SFT without signs of malignancy. In the first postoperative visit a partial paralysis of the right vocal cord occured, which could no longer be observed about five days later.

Conclusion Extrapleural SFTs in the head and neck are extremely rare and most commonly benign, although there have been a small number of malignant cases. Whereas a few parapharyngeal SFT have been reportet in literature a paralaryngeal location is not described until today. Treament of choice is surgical resection with negative margins.

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Publication History

Article published online:
10 June 2020