title: Solitary fibrous tumors of the head and neck: a clinicopathologic and radiologic review.
abstract: OBJECTIVE
  To describe the clinicopathologic and radiologic features of solitary fibrous tumors of the head and neck.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Tertiary referral center that performs head and neck surgical oncology.
  
  
  METHODS
  Twelve patients with solitary fibrous tumors of the head and neck identified from the pathology and soft tissue tumor databases at Memorial Sloan-Kettering Cancer Center, New York, NY, from 1990 to 2004. All cases were reviewed by 3 experienced pathologists, 1 of whom is an experienced soft tissue tumor pathologist. The diagnosis was confirmed by microscopic features on hematoxylin-eosin staining and by positive staining for CD34 and Bcl2 on immunohistochemical analysis. Tumors were scored for mitotic activity, cellularity, nuclear pleomorphism, necrosis, and the presence of a malignant component. Details on patient characteristics, tumor characteristics, previous treatment and surgery, adjuvant treatment, and outcome were recorded from clinical records.
  
  
  RESULTS
  Solitary fibrous tumors occurred in patients over a wide age range (27-78 years; median age, 52 years). Seven patients (58%) were women, and 5 (42%) were men. Most tumors presented as a slow-growing painless mass with a duration ranging from 2 months to 5 years. The tumors ranged from 1 x 1 cm to 6 x 5 cm. Patients presented with a subcutaneous mass of the scalp or face in 4 cases, intraoral mass in 4, sinonasal mass in 3, and paraspinal mass in 1. Computed tomographic and/or magnetic resonance imaging scans of 7 of the 12 patients showed well-circumscribed tumors that enhanced strongly with contrast. Treatment for all of the patients was surgical resection. Pathologic findings showed that 9 tumors were benign and 3 were malignant. Three patients had a positive surgical resection margin. All patients were alive at a median follow-up of 8 months (range, 1-76 months). Local recurrence occurred in 1 patient who had positive surgical margins 3 years after the initial surgery.
  
  
  CONCLUSIONS
  Solitary fibrous tumors of the head and neck region are rare and most commonly benign. The diagnosis depends on microscopic and immunohistochemical features, although imaging may help. Patients with these tumors can be safely treated with local excision, but tumors with positive margins require close follow-up over several years owing to the potential for late local recurrence.
authors.affiliation: Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Ganly
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.forename: Hilda E
authors.initials: HE
authors.lastname: Stambuk
authors.forename: Maria
authors.initials: M
authors.lastname: Coleman
authors.forename: Ronald
authors.initials: R
authors.lastname: Ghossein
authors.forename: Diane
authors.initials: D
authors.lastname: Carlson
authors.forename: Mark
authors.initials: M
authors.lastname: Edgar
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
mesh_terms: D000071443:12E7 Antigen; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D015815:Cell Adhesion Molecules / Q000032:analysis; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008938:Mitosis / Q000502:physiology; D018218:Neoplasms, Fibrous Tissue / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D040521:Subcutaneous Tissue / Q000473:pathology; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D000071443:12E7 Antigen; D015703:Antigens, CD; D018952:Antigens, CD34; D014408:Biomarkers, Tumor; C061828:CD99 protein, human; D015815:Cell Adhesion Molecules; D019253:Proto-Oncogene Proteins c-bcl-2