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Solitary Fibrous Tumors of the Head and Neck: A Multi-Institutional Clinicopathologic Study
- Source :
- The American journal of surgical pathology. 41(12)
- Publication Year :
- 2017
-
Abstract
- Solitary fibrous tumors (SFTs) of the head and neck are uncommon. Lesions previously diagnosed in the head and neck as hemangiopericytomas (HPCs), giant cell angiofibromas (GCAs), and orbital fibrous histiocytoma (OFHs) are now recognized as within the expanded spectrum of SFTs. To better understand the clinicopathologic profile of head and neck SFTs, we performed a multi-institutional study of 88 examples. There was no sex predilection (F:M ratio 1.2), and the median patient age was 52y (range 15>89). The sinonasal tract and orbit were the most common sites involved (30% and 25%), followed by the oral cavity and salivary glands (15% and 14%). Original diagnoses included HPC (25%), SFT (67%), and OFH (6%), with one SFT and one OFH noted as showing GCA-like morphology. On review, the predominant histologic pattern was classic SFT-like in 53% and cellular (former HPC-like) in 47%; lipomatous differentiation (8%) and giant cell angiofibroma-like pattern (7%) were less prevalent. Subsets demonstrated nuclear atypia (23%), epithelioid morphology (15%), or coagulative necrosis (6%). Infiltrative growth (49%) and osseous invasion (82%) were prevalent among evaluable cases. Of the 48 SFTs with follow-up (median 77mo, mean 100mo), 19 showed recurrence (40%). Of these, four patients were alive with disease and four dead of disease. Size and mitotic rate were negative prognosticators using a joint prognostic proportional hazards regression model. Three patients experienced metastasis, to lungs, parotid, bone, and skull base, including one case showing overtly sarcomatous “dedifferentiation”. As a group, SFTs present in a wide anatomic and morphologic spectrum in the head and neck. Only rare examples metastasize or cause death from disease. However, the fairly high local recurrence rate underscores their aggressive potential and highlights the importance of prospective recognition.
- Subjects :
- 0301 basic medicine
Male
Solitary fibrous tumor
Pathology
Time Factors
Kaplan-Meier Estimate
Metastasis
0302 clinical medicine
Risk Factors
Nuclear atypia
Aged, 80 and over
Middle Aged
Immunohistochemistry
medicine.anatomical_structure
Coagulative necrosis
Treatment Outcome
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Solitary Fibrous Tumors
Disease Progression
Female
Anatomy
Adult
medicine.medical_specialty
Adolescent
Disease-Free Survival
Article
Pathology and Forensic Medicine
03 medical and health sciences
Young Adult
medicine
Biomarkers, Tumor
Mitotic Index
Humans
Neoplasm Invasiveness
Aged
Cell Proliferation
Proportional Hazards Models
Retrospective Studies
Hemangiopericytoma
business.industry
Sinonasal Tract
medicine.disease
United States
Skull
030104 developmental biology
Giant cell
Surgery
Neoplasm Recurrence, Local
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 15320979
- Volume :
- 41
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- The American journal of surgical pathology
- Accession number :
- edsair.doi.dedup.....c11a2cf92f5b3db2346c6acc03db3775