Parotid gland solitary fibrous tumor with mandibular bone destruction and aggressive behavior

Abstract

Introduction: Solitary fibrous tumor is associated with serosal surfaces. Location in the salivary glands is extremely unusual. Extrathoracic tumors have an excellent prognosis associated with their benign clinical behavior. We report an aggressive and recurrent case of this tumor. We review the clinical presentation, inmunohistochemical profiles and therapeutic approaches. Case Report: A 73-years-old woman presented a mass in her right parotid gland. She had a past history of right superficial parotidectomy due to a neurilemoma. FNAB and magnetic resonance were non-specific. After a tumor resection, microscopic findings were spindled tumor cells with reactivity to CD34, bcl-2 and CD99 and the tumor was diagnosed as Solitary Fibrous Tumor. The patient suffered two recurrences and the tumor had a histological aggressive behavior and a destruction of the cortical bone of the mandible adjacent to the mass. A marginal mandibulectomy with an alveolar inferior nerve lateralization was performed. Conclusions: Solitary fibrous tumor is a very rare tumor. Usually, they are benign, but occasionally they can be aggressive. Complete resection is the most important prognostic factor and no evidence supports the efficacy of any therapy different to surgery. Due to the unknown prognosis and to the small number of cases reported, a long-term follow-up is guaranteed. Key words:Solitary fibrous tumor, parotid mass, parotid gland, salivary gland, rare tumors.

Solitary fibrous tumor occurring in the parotid gland: a case report

“…Other features can be observed, such as stromal myxoid change, inflammatory cells and isolated multinucleated stromal tumor giant cells [ 3 , 16 ]. Histological features suggesting malignancy include high mitotic rate (four or more mitoses in 10 high power fields), hypercellularity, moderate to marked atypia and nuclear pleomorphism, tumor necrosis and infiltrative borders [ 8 ]. These features were absent in the case of our patient.…”

Solitary Fibrous Tumour of the Parotid Gland: A Case Report and Review of the Literature

“…There may also be variable vascularity with numerous ramifying vessels and hyalinised walls [ 7 ]. Malignant invasion of the mandible has been reported in one case of parotid SFT [ 8 ].…”

Diagnosis of solitary fibrous tumor in the submandibular gland: Case report and literature review

“…The low incidence of SFTs makes preoperative imaging diagnosis challenging, and the diagnosis mainly relies on histopathologic and immunohistochemical (IHC) analysis after excision. The primary treatment is complete surgical excision, and long‐term follow‐up is necessary to monitor for possible local recurrence or malignancy transformation …”

“…The primary treatment is complete surgical excision, 7 and long-term follow-up is necessary to monitor for possible local recurrence or malignancy transformation. 8 We report an unusual case of SFT in the submandibular region that was initially misdiagnosed by ultrasound (US) and describe its clinical, US, and IHC features, its treatment, and briefly review the literature. Figure 1A).…”