title: Head and neck solitary fibrous tumors: a rare and challenging entity.
abstract: The objective of this study is to analyze the outcome of treatment for solitary fibrous tumors (SFTs) in the head and neck area. SFTs present as slow-growing masses, often with local compressive symptoms that are difficult to distinguish from other soft-tissue tumors. SFTs are commonly treated using local excision without adjuvant therapy. To date, only heterogeneous small series have been published, documenting the treatment results and outcome with these tumors. Retrospective study of patients with histopathologically confirmed SFT treated at two tertiary referral hospitals between 2004 and 2014. Eight men and four women with histologically confirmed SFT were identified in the records. Their age range was 37-82 years (mean 57.8 years). The mean follow-up period for eight patients was 6.75 years (range 1-24 years). Four patients were lost to follow-up. Sublocalizations were neck (n = 3), orbit (n = 2), paranasal sinus (n = 2), cheek (n = 2), hard palate (n = 1), parotid gland (n = 1), and tongue (n = 1). The first-line treatment for all of the tumors identified was surgical excision. In four cases, the surgical margins were narrow or unclear due to piecemeal resection in the paranasal sinus and orbit (n = 3) or a tumor location deep in the parapharyngeal space (n = 1). Recurrences developed in two of these cases (in the orbit and parapharyngeal space), and the other two patients were lost to follow-up. Radiotherapy and chemotherapy were not administered as first-line treatments. Overall, the local recurrence rate (n = 2/8) was 25 %. The disease-specific survival rate was 100 %. These results are consistent with the literature data and show that safe surgical excision, without opening of the tumor capsule, reduces the risk of local recurrence and leads to a favorable outcome. Tumors in the head and neck often represent a surgical challenge, and wide surgical margins are rarely possible due to the complex three-dimensional anatomic compartments in the region. Head and neck surgeons should therefore be aware that there is an increased risk of recurrence in these patients; tightly scheduled follow-up visits are mandatory for at least 10 years, if not longer. Radiotherapy only appears to be an option in patients with unresectable tumors or when wide surgical excision would cause severe functional morbidity.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Mainz University Hospital, Langenbeckstrasse 1, 55101, Mainz, Germany. julian.kuenzel@gmx.net.
authors.forename: Julian
authors.initials: J
authors.lastname: Künzel
authors.affiliation: Department of Pathology, Mainz University Hospital, Mainz, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hainz
authors.affiliation: Department of Maxillofacial Surgery, Mainz University Hospital, Mainz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ziebart
authors.affiliation: Department of Ophthalmology, Mainz University Hospital, Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Pitz
authors.affiliation: Department of Otorhinolaryngology, University of Göttingen Medical Center, Göttingen, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Ihler
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Mainz University Hospital, Langenbeckstrasse 1, 55101, Mainz, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Strieth
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Mainz University Hospital, Langenbeckstrasse 1, 55101, Mainz, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Matthias
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000175:diagnosis; D054364:Solitary Fibrous Tumors / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors
keywords: CD34; Hemangiopericytoma; SFT; Solitary fibrous tumor