Solitary fibrous tumor in the upper eylid – a rare manifestation in the ENT area

Introduction Solitary fibrous tumors (SFT) are rare spindle-cell tumors that occur mainly pleural. Very rarely, these tumors occur extrapleural. In the ENT area, SFTs have been described in the nasal cavity, thyroid, parotid gland and orbit. SFTs are slowly growing, painless tumors. On MRI, SFTs present with homogeneous low-to-intermediate signal intensity as well as intense enhancement. Immunohistochemical analysis shows a staining for CD34 and show a nuclear positivity for STAT6. SFTs are usually benign, but in a few cases they can also present as malignant tumors. SFTs are usually treated with a complete surgical excision.

Case A 70-year-old female patient came to our ENT clinic with a relapse of a painless, slowly growing mass in the area of the right upper eyelid. 12 months ago a tumor has already been removed from the right upper eyelid alio loco. However, the histological findings were not known to the patient. On MRI, the tumor was presented as a well distinguishable solid mass in the area of the right upper eyelid with slight enhancement in T1 and T2 weighted imaging. The tumor was subsequently removed in toto via upper blepharoplasty.

Result Histopathological findings showed SFT with nuclear positivity for STAT6 and positive staining for CD99 and CD34.

Conclusions SFTs in the ENT area are rare. These tumors consist of fibrous tissue and show a nuclear positivity for STAT6 in immunohistochemistry, which is considered to be proof for this specific tumor entity. SFTs should be included in possible differential diagnostic considerations for unclear, symptomless and well distinguishable masses in the ENT area. Since the tumor can also appear as a malignant tumor in rare cases, a complete excision and regular clinical tumor follow-up is highly recommended.

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Publication History

Article published online:
10 June 2020