DOI QR코드

DOI QR Code

Orbital Solitary Fibrous Tumor : A Case Report and Diagnostic Clues

  • Ha, Joo-Kyung (Departments of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Park, Bong-Jin (Departments of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Kim, Yun-Hwa (Departments of Pathology, School of Medicine, Kyung Hee University) ;
  • Lim, Young-Jin (Departments of Neurosurgery, School of Medicine, Kyung Hee University)
  • Published : 2009.07.31

Abstract

Orbital solitary fibrous tumor (SFT) is a rare tumor originating from the mesenchyme. We describe the clinical presentations, radiological and operative findings, and pathological features of a patient with orbital SFT. The patient was a 46-year-old female who presented with progressive proptosis advanced for 20 months. On ophthalmological examination, no visual impairment was detected, but left eye was found to be obviously protruded on exophthalmometry. Orbital magnetic resonance imaging showed a 2.5 ${\times}$ 2 ${\times}$ 2 cm, intensely enhanced mass in the left orbit, which compressed the eyeball forward and the optic nerve downward. The patient underwent frontal craniotomy with superior orbitotomy and gross total resection was performed for the tumor. The histopathological diagnosis including immunohistochemistry was a SFT. After the surgery, proptosis was markedly relieved without visual impairment. Although orbital SFT is extremely rare, it should be considered in the differential diagnosis of orbital tumors. Clinical presentations such as painless proptosis and CD34 immunoreactivity play a significant role in differentiating orbital SFT from other spindle-cell neoplasms of the orbit.

Keywords

References

  1. Ali SZ, Hoon V, Hoda S, Heelan R, Zakowski MF : Solitary fibrous tumor. A cytologic-histologic study with clinical, radiologic, and immunohistochemical correlations. Cancer 81 : 116-121, 1997 https://doi.org/10.1002/(SICI)1097-0142(19970425)81:2<116::AID-CNCR5>3.0.CO;2-Q
  2. Bernardini FP, de Conciliis C, Schneider S, Kersten RC, Kulwin DR : Solitary fibrous tumor of the orbit : is it rare? Report of a case series and review of the literature. Ophthalmology 110 : 1442-1448, 2003 https://doi.org/10.1016/S0161-6420(03)00459-7
  3. Brunnemann RB, Ro JY, Ordonez NG, Mooney J, El-Naggar AK, Ayala AG : Extrapleural solitary fibrous tumor : a clinicopathologic study of 24 cases. Mod Pathol 12 : 1034-1042, 1999
  4. Carneiro SS, Scheithauer BW, Nascimento AG, Hirose T, Davis DH: Solitary fibrous tumor of the meninges : a lesion distinct from fibrous meningioma. A clinicopathologic and immunohistochemical study. Am J Clin Pathol 106 : 217-224, 1996
  5. Cassarino DS, Auerbach A, Rushing EJ : Widely invasive solitary fibrous tumor of the sphenoid sinus, cavernous sinus, and pituitary fossa. Ann Diagn Pathol 7 : 169-173, 2003 https://doi.org/10.1016/S1092-9134(03)00016-9
  6. Clayton AC, Salom$\ddot{a}$o DR, Keeney GL, Nascimento AG : Solitary fibrous tumor : a study of cytologic features of six cases diagnosed by fine-needle aspiration. Diagn Cytopathol 25 : 172-176, 2001 https://doi.org/10.1002/dc.2032
  7. Dietrich CG, Roeb E, Breuer E, Matern S : [Solitary fibrous thoracic wall tumor. Progression with percutaneous radiotherapy.] Dtsch Med Wochenschr 126 : 12-15, 2001 https://doi.org/10.1055/s-2001-9884
  8. England DM, Hochholzer L, McCarthy MJ : Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol 13 : 640-658, 1989 https://doi.org/10.1097/00000478-198908000-00003
  9. Festa S, Lee HJ, Langer P, Klein KM : Solitary fibrous tumor of the orbit : CT and pathologic correlation. Neuroradiology 41 : 52-54, 1999 https://doi.org/10.1007/s002340050705
  10. Fukunaga M, Ushigome S, Nomura K, Ishikawa E : Solitary fibrous tumor of the nasal cavity and orbit. Pathol Int 45 : 952-957, 1995 https://doi.org/10.1111/j.1440-1827.1995.tb03421.x
  11. Gali$\acute{e}$ M, Tieghi R, Cavazzini L, Clauser L : Solitary fibrous tumor of the orbit : a case report. Int J Oral Maxillofac Surg 34 : 331-333, 2005 https://doi.org/10.1016/j.ijom.2004.05.011
  12. Giuffre I, Faiola A, Bonanno E, Liccardo G : Solitary fibrous tumor of the orbit. Case report and review of the literature. Surg Neurol 56 : 242-246, 2001 https://doi.org/10.1016/S0090-3019(01)00597-3
  13. Glazer-Hockstein C, Syed NA, Warhol M, Gausas RE : Malignant solitary fibrous tumor metastatic to the orbit. Ophthal Plast Reconstr Surg 20 : 471-473, 2004 https://doi.org/10.1097/01.IOP.0000144786.56696.98
  14. Hayashi S, Kurihara H, Hirato J, Sasaki T : Solitary fibrous tumor of the orbit with extraorbital extension : case report. Neurosurgery 49 : 1241-1245, 2001 https://doi.org/10.1097/00006123-200111000-00042
  15. Heathcote JG : Pathology update : solitary fibrous tumour of the orbit. Can J Ophthalmol 32 : 432-435, 1997
  16. Jang JW, Kim CH, Yoo CW, Moon JG : Intracranial solitary fibrous tumor. J Korean Neurosurg Soc 39 : 64-67, 2006
  17. Kim HY, Lee SY, Kang SJ, Kim HJ : Solitary fibrous tumor of the orbit : a poorly-recognized orbital lesion. Acta Ophthalmol Scand 77 : 704-708, 1999 https://doi.org/10.1034/j.1600-0420.1999.770621.x
  18. Krishnakumar S, Subramanian N, Mohan ER, Mahesh L, Biswas J, Rao NA : Solitary fibrous tumor of the orbit : a clinicopathologic study of six cases with review of the literature. Surv Ophthalmol 48 : 544-554, 2003 https://doi.org/10.1016/S0039-6257(03)00087-0
  19. Lucci LM, Anderson RL, Harrie RP, Mamalis N, Coffin C, Crandall DC : Solitary fibrous tumor of the orbit in a child. Ophthal Plast Reconstr Surg 17 : 369-373, 2001 https://doi.org/10.1097/00002341-200109000-00012
  20. Martin AJ, Fisher C, Igbaseimokumo U, Jarosz JM, Dean AF : Solitary fibrous tumours of the meninges : case series and literature review. J Neurooncol 54 : 57-69, 2001 https://doi.org/10.1023/A:1012553119349
  21. Meyer D, Riley F : Solitary fibrous tumor of the orbit : a clinicopathologic entity that warrants both a heightened awareness and an atraumatic surgical removal technique. Orbit 25 : 45-50, 2006 https://doi.org/10.1080/01676830500506101
  22. Miettinen M, Shekitka KM, Sobin LH : Schwannomas in the colon and rectum : a clinicopathologic and immunohistochemical study of 20 cases. Am J Surg Pathol 25 : 846-855, 2001 https://doi.org/10.1097/00000478-200107000-00002
  23. Miller NR : New concepts in the diagnosis and management of optic nerve sheath meningioma. J Neuroophthalmol 26 : 200-208, 2006 https://doi.org/10.1097/01.wno.0000235569.19131.ac
  24. O'Donovan DA, Bilbao JM, Fazl M, Antonyshyn OM : Solitary fibrous tumor of the orbit. J Craniofac Surg 13 : 641-644, 2002 https://doi.org/10.1097/00001665-200209000-00009
  25. Perry A, Scheithauer BW, Nascimento AG : The immunophenotypic spectrum of meningeal hemangiopericytoma : a comparison with fibrous meningioma and solitary fibrous tumor of meninges. Am J Surg Pathol 21 : 1354-1360, 1997 https://doi.org/10.1097/00000478-199711000-00010
  26. Polito E, Tosi M, Toti P, Schurfeld K, Caporossi A : Orbital solitary fibrous tumor with aggressive behaviorThree cases and review of the literature. Graefes Arch Clin Exp Ophthalmol 240 : 570-574, 2002 https://doi.org/10.1007/s00417-002-0486-7
  27. Romer M, Bode B, Sch$\ddot{u}$knecht B, Schmid S, Holzmann D : Solitary fibrous tumor of the orbit--two cases and a review of the literature. Eur Arch Otorhinolaryngol 262 : 81-88, 2005 https://doi.org/10.1007/s00405-003-0731-7
  28. Rosenberg AE, O'Connell JX, Dickersin GR, Bhan AK : Expression of epithelial markers in malignant fibrous histiocytoma of the musculoskeletal system : an immunohistochemical and electron microscopic study. Hum Pathol 24 : 284-293, 1993 https://doi.org/10.1016/0046-8177(93)90039-J
  29. Suster S, Fisher C, Moran CA : Expression of bcl-2 oncoprotein in benign and malignant spindle cell tumors of soft tissue, skin, serosal surfaces, and gastrointestinal tract. Am J Surg Pathol 22 : 863-872, 1998 https://doi.org/10.1097/00000478-199807000-00008
  30. Suzuki SO, Fukui M, Nishio S, Iwaki T : Clinicopathological features of solitary fibrous tumor of the meninges : an immunohistochemical reappraisal of cases previously diagnosed to be fibrous meningioma or hemangiopericytoma. Pathol Int 50 : 808-817, 2000 https://doi.org/10.1046/j.1440-1827.2000.01120.x
  31. Tihan T, Viglione M, Rosenblum MK, Olivi A, Burger PC : Solitary fibrous tumors in the central nervous system. A clinicopathologic review of 18 cases and comparison to meningeal hemangiopericytomas. Arch Pathol Lab Med 127 : 432-439, 2003
  32. Vallat-Decouvelaere AV, Dry SM, Fletcher CD : Atypical and malignant solitary fibrous tumors in extrathoracic locations : evidence of their comparability to intra-thoracic tumors. Am J Surg Pathol 22 : 1501-1511, 1998 https://doi.org/10.1097/00000478-199812000-00007
  33. Warraich I, Dunn DM, Oliver JW : Solitary fibrous tumor of the orbit with epithelioid features. Arch Pathol Lab Med 130 : 1039-1041, 2006
  34. Westra WH, Gerald WL, Rosai J : Solitary fibrous tumor. Consistent CD34 immunoreactivity and occurrence in the orbit. Am J Surg Pathol 18 : 992-998, 1994 https://doi.org/10.1097/00000478-199410000-00003
  35. Wright JE, Stewart WB, Krohel GB : Clinical presentation and management of lacrimal gland tumours. Br J Ophthalmol 63 : 600-606, 1979 https://doi.org/10.1136/bjo.63.9.600

Cited by

  1. Orbital solitary fibrous tumor: A clinicopathologic correlation and review of literature vol.4, pp.3, 2011, https://doi.org/10.4103/0974-620x.91274
  2. MRI Study of Solitary Fibrous Tumor in the Orbit vol.199, pp.4, 2009, https://doi.org/10.2214/ajr.11.8477
  3. Orbital tuberculosis manifesting as proptosis in an immunocompromised host vol.33, pp.2, 2009, https://doi.org/10.4103/2589-0557.102129
  4. Correlation between Clinical Features, Imaging and Pathologic Findings in Recurrent Solitary Fibrous Tumor of the Orbit vol.32, pp.6, 2009, https://doi.org/10.3109/01676830.2013.815222
  5. A Solitary Fibrous Tumor with Giant Cells in the Lacrimal Gland: A Case Study vol.47, pp.2, 2009, https://doi.org/10.4132/koreanjpathol.2013.47.2.158
  6. Malignant Solitary Fibrous Tumor of Tandem Lesions in the Skull and Spine vol.54, pp.3, 2013, https://doi.org/10.3340/jkns.2013.54.3.246
  7. Orbital Solitary Fibrous Tumor: A Case Series with Review of the Literature vol.33, pp.2, 2014, https://doi.org/10.3109/01676830.2013.853806
  8. Solitary fibrous tumor of the submandibular region vol.9, pp.2, 2009, https://doi.org/10.3892/ol.2014.2785
  9. Radiologic and Pathologic Findings of a Huge Solitary Fibrous Tumor of the Liver with Malignant Transformation: A Case Report vol.17, pp.1, 2009, https://doi.org/10.5812/iranjradiol.68449