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Tariq MU, Alsulaiman A, Kashif A, Keshk E, Alhassani SH, Alkhudaidi H. Solitary Fibrous Tumor of Head and Neck Region: A Series of Three Cases at an Uncommon Location With a Review of the Literature. Cureus 2024; 16:e58213. [PMID: 38741857 PMCID: PMC11090618 DOI: 10.7759/cureus.58213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 05/16/2024] Open
Abstract
Solitary fibrous tumors (SFTs) uncommonly involve the head and neck region. Head and neck SFTs (HNSFTs) exhibit diverse histological features and can mimic several neoplasms with different treatment and behavior. Herein, we report the clinicopathological features of three cases of HNSFT. Case 1 was a 29-year-old female who presented with a nasal cavity mass measuring 3.5 cm. The patient underwent surgical excision. Microscopic examination revealed classic histological and immunohistochemical (IHC) features of SFT. Unusual histological features included epithelioid morphology, clear cells, and edematous change. She developed local recurrence after 11 months, which was also treated with surgery. Case 2 was a 55-year-old male who developed a 1-cm mass at the buccal mucosa. Surgical excision of the tumor was performed. The tumor was completely circumscribed microscopically. Characteristic histological and IHC features of SFT were identified. Unusual histological features observed were an adenomatous pattern, clear cells, and myxoid change. The patient was alive and disease-free at the 12-month follow-up. Case 3 was a 59-year-old female presenting with a medial canthus mass measuring 1.4 cm. The patient underwent surgical excision. Histological and IHC features observed were diagnostic for SFT. Unusual histological features identified were wavy nuclei and multinucleated stromal giant cells. The patient was alive and disease-free at the 124-month follow-up. Diagnosis of SFT can be challenging in unusual locations like the head and neck region. In addition, the histological spectrum of HNSFT is diverse. Therefore, knowledge about unusual histological features and classic IHC expression is essential for establishing correct diagnosis. Long-term follow-up is recommended because of the risk of recurrence in HNSFT.
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Affiliation(s)
- Muhammad Usman Tariq
- Histopathology Unit, Laboratory Department, Al Hada Armed Forces Hospital, Taif, SAU
| | | | - Ammara Kashif
- Histopathology Unit, Laboratory Department, Al Hada Armed Forces Hospital, Taif, SAU
| | - Eman Keshk
- Histopathology Unit, Laboratory Department, Al Hada Armed Forces Hospital, Taif, SAU
| | - Salwa H Alhassani
- Genetics Division, Laboratory Department, Al Hada Armed Forces Hospital, Taif, SAU
| | - Hessa Alkhudaidi
- Forensic Toxicology Section, Laboratory Department, Al Hada Armed Forces Hospital, Taif, SAU
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Su Z, Wei J, Yuan X. Giant cell-rich solitary fibrous tumour of the urinary bladder: case report of an unusual histological variant and literature review. Diagn Pathol 2024; 19:20. [PMID: 38263153 PMCID: PMC10804537 DOI: 10.1186/s13000-024-01442-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/07/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Giant cell-rich solitary fibrous tumour (GCR-SFT), previously referred to as giant cell angiofibroma, is an uncommon soft tissue tumour that classically occurs in the orbit but very rarely presents in deep organs. Here, we present a case of GCR-SFT occurring in the urinary bladder, which is one of the unusual histological subtypes of SFT. CASE PRESENTATION A 56-year-old man was incidentally found to have a mass measuring 4.5 × 4.3 × 4.0 cm located in the left posterior wall of the bladder by computed tomography during a physical examination. The lesion was confirmed as GCR-SFT by pathological examination after laparoscopic radical surgery. Histopathologically, the tumour was a well-circumscribed, nonencapsulated lesion that was composed of bland spindle-ovoid tumour cells alternating with hypocellular and hypercellular areas, staghorn-like vasculatures and scattered large dark-stained multinucleate giant cells lining pseudovascular spaces. The spindle-ovoid cells and multinucleate giant cells showed strong and diffuse expression of CD34 and nuclear STAT6. In addition, the hallmark of the NAB2ex4-STAT6ex5 fusion gene was detected by RT‒PCR. The patient was classified as having a low risk of recurrence or metastasis according to the risk stratification criteria. The patient underwent regular follow-up for 34 months after surgery, and there was no evidence of local recurrence or metastasis. CONCLUSION This is the first reported case of GCR-SFT occurring in the urinary bladder with underlying NAB2ex4-STAT6ex5 fusion. Complete surgical excision of the tumour and long-term follow-up are recommended to ensure no local recurrence or metastasis.
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Affiliation(s)
- Zhou Su
- Department of Pathology, Maoming People's Hospital, Guangdong Medical University, Maoming City, China
| | - Jianguo Wei
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou City, China
| | - Xiaolu Yuan
- Department of Pathology, Maoming People's Hospital, Guangdong Medical University, Maoming City, China.
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Pol JN, Patil DB, Desai SS, Calcuttawala AB. Malignant recurrent orbital solitary fibrous tumor. INDIAN J PATHOL MICR 2023; 66:819-822. [PMID: 38084539 DOI: 10.4103/ijpm.ijpm_713_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Solitary fibrous tumor (SFT) is a rare mesenchymal tumor of fibroblastic origin commonly occurring in pleura. It can occur at many extrapleural sites but is rare in orbit. Most cases are benign and recurrence is not unusual in the head and neck and orbit and is usually due to incomplete surgical excision. However, malignant transformation (MT) in orbital SFT is extremely unusual. We present a case of orbital SFT in adult male who developed recurrence with MT eight years after initial surgical excision. He underwent left orbital exenteration. The recurrent tumor revealed features of malignancy with areas exhibiting morphology typical of SFT. The immunochemistry confirmed the diagnosis of SFT with MT. The patient was given adjuvant radiation and was disease free for the last 18 months. Identification of malignancy in orbital SFT is important for the patient to receive appropriate postoperative treatment, as seen in the present case.
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Affiliation(s)
- Jaydeep N Pol
- Department of Pathology, Mahatma Gandhi Cancer Hospital, Miraj, Maharashtra, India
| | - Dipti B Patil
- Department of Maxillofacial Surgery, Mahatma Gandhi Cancer Hospital, Miraj, Maharashtra, India
| | - Sharad S Desai
- Department of Oncosurgery, Mahatma Gandhi Cancer Hospital, Miraj, Maharashtra, India
| | - Adnan B Calcuttawala
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital, Miraj, Maharashtra, India
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Jot K, Nayyar V, Surya V, Mishra D, Sowmya SV, Augustine D, Indu M, Haragannavar VC. A multicentric case study of fibroblastic and myofibroblastic oral spindle cell lesions. J Oral Maxillofac Pathol 2023; 27:629-641. [PMID: 38304501 PMCID: PMC10829460 DOI: 10.4103/jomfp.jomfp_282_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 02/03/2024] Open
Abstract
Context Spindle cell lesions comprise a vast plethora of benign and malignant lesions with similar clinical and radiographic features. Their overlapping histopathologic features ensure a diagnostic dilemma. Aim The current multicentric study aims to delineate fibroblastic and myofibroblastic oral spindle cell lesions based on cytomorphology and comprehensive immunohistochemical analysis. Settings and Design The experimental study was conducted at MS Ramaiah University of Applied Sciences, Bangalore, and All India Institute of Applied Sciences, Delhi. Methods and Material A comprehensive histological scoring criteria and panel of immunohistochemical makers (STAT6, CD31, CD34, S100, SMA, vimentin, pan-CK, HHF-35, Ki67, ALK, desmin, HMB-45, SATB2, ERG, EMA and CD99) were employed concurrently for the first time for fibroblastic and myofibroblastic oral spindle cell lesions. The data obtained was tabulated and studied. Statistical Analysis Used NA. Results: Using cytological scoring criteria and panel of immunohistochemical makers, the cases analysed and characterized were desmoplastic fibroma, fibrosarcoma, leiomyosarcoma, nodular fasciitis, neurofibroma and epithelioid inflammatory myofibroblastic sarcoma (EIMS). Conclusions The diagnostic strategies need to be upgraded for the diagnosis of spindle cell lesions. Emphasis must be placed on cytomorphology, an immunohistochemistry (IHC) panel of markers is imperative for the accurate diagnosis of fibroblastic and myofibroblastic oral spindle cell lesions.
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Affiliation(s)
- Kiran Jot
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Vivek Nayyar
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Varun Surya
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Deepika Mishra
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - SV Sowmya
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, Karnataka, India
| | - Dominic Augustine
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, Karnataka, India
| | - M Indu
- Department of Oral Pathology, Government Dental College, Kottayam, Kerala, India
| | - Vanishri C. Haragannavar
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, Karnataka, India
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Cunha JLS, Cavalcante IL, Barros EF, de Sousa Neto SS, Cavalcante RB, Turatti E, de Mendonça EF, de Albuquerque-Júnior RLC, Anbinder AL, Fragata da Silva D, Duarte IX, Nonaka CFW, Alves PM, de Almeida OP, de Andrade BAB. Oral solitary fibrous tumors: A collaborative clinicopathologic study of 19 cases. Oral Dis 2023. [PMID: 37731190 DOI: 10.1111/odi.14737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/31/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To report the clinicopathologic features of 19 oral solitary fibrous tumors (SFTs). METHODS Clinical data were collected from the records of seven pathology services. All cases were re-evaluated by HE staining and confirmed by immunohistochemistry. RESULTS The series comprised 11 females (57.9%) and 8 males (42.1%), with a mean age of 47.3 ± 14.7 years (range: 22-71 years) and a 1.3:1 female-to-male ratio. Most tumors affected the buccal mucosa (n = 7; 36.8%) and presented clinically as an asymptomatic solitary submucosal well-circumscribed nodule with coloration similar to the oral mucosa. Morphologically, most SFTs (n = 10; 52.6%) exhibited a classic hybrid pattern characterized by a well-circumscribed proliferation of densely cellular areas alternating with hypocellular areas in a variably collagenous vascular stroma. Remnants of accessory salivary glands were observed in two cases (n = 2; 10.5%). All tumors were positive for STAT6 and CD34 (n = 19; 100%). Outcome information was available from 6 patients (31.6%), with clinical follow-up ranging from 6 to 24 months (mean ± SD, 9.5 ± 6.8 months), and none developed local recurrence. CONCLUSIONS Oral SFTs are rare and often clinically misdiagnosed. Pathologists should consider SFT in the differential diagnosis of oral spindle cell tumors. Accurate diagnosis requires careful morphological evaluation supported by immunohistochemical analysis.
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Affiliation(s)
- John Lennon Silva Cunha
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
- Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, Brazil
| | - Israel Leal Cavalcante
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- School of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, Brazil
| | | | - Sebastião Silvério de Sousa Neto
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
- Department of Dentistry, Federal University of Goiás (UFG), Goiânia, Brazil
| | | | - Eveline Turatti
- School of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, Brazil
| | | | | | - Ana Lia Anbinder
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | | | | | | | | | - Oslei Paes de Almeida
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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Tariq MU, Asghari T, Armstrong SM, Ahmed A, Fritchie K, Din NU. Solitary fibrous tumor of head and neck region; A clinicopathological study of 67 cases emphasizing the diversity of histological features and utility of various risk stratification models. Pathol Res Pract 2023; 249:154777. [PMID: 37639955 DOI: 10.1016/j.prp.2023.154777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 08/17/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Head and neck SFT (HNSFT) exhibit diverse histological features and can mimic various neoplasms with different treatment and behavior. While risk stratification systems have been developed for this tumor at various anatomic sites, a specific scheme for head and neck tumors is lacking. Our aim was to describe the histologic patterns present in HNSFT cases as well as assess the utility of risk assessment models in this location. METHODS A retrospective review of pathology reports and microscopy glass slides of HNSFT cases diagnosed between January 2010 and August 2022 was performed.STAT6 was additionally performed on selected cases if needed. Follow up was obtained and various risk stratification models were applied. RESULTS Sixty seven cases of HNSFT were collected (age range from 11 to 87 years; median 42 years; M:F 1.6:1). Most common tumor sites were orbit (n = 21; 31.3 %), sinonasal tract (n = 18; 26.9 %), and oral cavity (n = 13; 19.4 %). Tumor size ranged from 1 to 16 cm (median 4cm). Apart from common histological features, tumor cells also showed focal epithelioid morphology, clear cell change and nuclear atypia in a subset of cases. Stromal findings included myxoid and lipomatous change, pseudoglandular spaces, pseudovascular spaces and multinucleated stromal giant cells. CD34 and STAT6 were expressed in 57/67 (85.1 %) and 56/56 (100 %) cases, respectively. Recurrence was observed in 4/26 (15.4 %) cases, while none (0/22) of the patients experienced distant metastasis (follow up 1-150 months; median 20.5 months). Clinical outcome was partially concordant with risk-categories of different risk stratification models. CONCLUSION Knowledge about histological diversity of HNSFT is essential for establishing correct diagnosis. Current risk stratification models do not perfectly predict outcome, and larger studies are needed to develop more accurate criteria for aggressive behavior.
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Affiliation(s)
- Muhammad Usman Tariq
- Department of Histopathology, Al Hada Armed Forces Hospital, Taif Region, Kingdom of Saudi Arabia.
| | - Tamana Asghari
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan.
| | - Susan M Armstrong
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland OH, USA.
| | - Arsalan Ahmed
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan.
| | - Karen Fritchie
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland OH, USA.
| | - Nasir Ud Din
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan.
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Zhang J, Han S, Zhao Y, Song P, Zhang H, Zhang J, Ding D, Wu Y. A case report of solitary fibrous tumor of the thyroid gland and literature review. Medicine (Baltimore) 2023; 102:e34710. [PMID: 37653837 PMCID: PMC10470733 DOI: 10.1097/md.0000000000034710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 09/02/2023] Open
Abstract
RATIONALE A solitary fibrous tumor (SFT) is an uncommon soft tissue tumor that was first discovered in the pleura. Although SFTs have been documented in other extra-pleural sites, an SFT in the thyroid gland is highly unusual. An SFT of the thyroid gland can be difficult to diagnose, and there is little information about their Underlying biological behavior. PATIENT CONCERNS We present a case of a 63-year-old man with a progressively growing left-neck mass detected 1 month ago, which was pathologically confirmed to be a benign SFT of the thyroid gland. DIAGNOSIS Postoperative pathological examination of the tumor revealed an SFT. Immunopathological examination was consistent with the diagnosis of an SFT. INTERVENTIONS The patient underwent surgical resection of the SFT. OUTCOMES The patient was recurrence-free during 1.5 years of follow-up. LESSONS Surgical excision is beneficial in SFTs that show no histological signs of malignancy, such as pleomorphism, enhanced mitotic activity, necrosis, bleeding, or capsular invasion. However, because the biologic activity remains unknown, meticulous long-term monitoring is required.
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Affiliation(s)
- Jin Zhang
- Clinical Medical College of Jining Medical University, Jining, People’s Republic of China
| | - Simin Han
- Clinical Medical College of Jining Medical University, Jining, People’s Republic of China
| | - Yufeng Zhao
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, People’s Republic of China
| | - Panpan Song
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, People’s Republic of China
| | - Hui Zhang
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, People’s Republic of China
| | - Jiafu Zhang
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, People’s Republic of China
| | - Detao Ding
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, People’s Republic of China
| | - Yungang Wu
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining, People’s Republic of China
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Rooper LM, Gagan J, Bishop JA. A Low Grade Nasopharyngeal sarcoma With FUS::NACC1 Fusion and Immunohistochemical Evidence of Epithelial Differentiation: Expanding the Clinicopathologic Spectrum of an Emerging Entity. Head Neck Pathol 2023; 17:253-258. [PMID: 36169794 PMCID: PMC10063715 DOI: 10.1007/s12105-022-01488-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND RNA sequencing of unclassified soft tissue tumors has allowed for definition of multiple new entities. Antonescu et al. recently reported three case of low grade sarcoma with recurrent EWSR1/FUS::NACC1 fusion and distinctive storiform architecture that were suggestive of a novel tumor type. METHODS Here, we present a case of an additional sarcoma with FUS::NACC1 fusion that arose in the head and neck and showed immunohistochemical evidence of epithelial differentiation. RESULTS A 41 year old woman presented with throat and inner ear pain and was found to have a nasopharyngeal mass. Biopsy highlighted a spindle cell neoplasm composed of bland cells arranged in a tight storiform pattern. On immunohistochemistry, the tumor cells were focally positive for S100 in a fibrillary pattern but were also positive for high molecular weight cytokeratin, p40, and CD34. RNA sequencing demonstrated a FUS::NACC1 fusion. The patient remains free of disease 2 years after surgical resection. CONCLUSION These findings confirm the previously-reported recurrent storiform histology in sarcomas with EWSR1/FUS::NACC1 fusion while simultaneously expanding the immunohistochemical spectrum of this entity to include overt epithelial differentiation. With involvement of a head and neck mucosal site, these findings also expand the differential diagnosis to include multiple mesenchymal entities including spindle cell squamous cell carcinoma. Further recognition of this emerging entity via expanded RNA sequencing panels will be necessary to determine the prevalence of these unique features.
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Affiliation(s)
- Lisa M Rooper
- Department of Pathology, The Johns Hopkins University School of Medicine, 401 N. Broadway, 2242, 21231, Weinberg, Baltimore, MD, USA.
- Department of Oncology, The Johns Hopkins University School of Medicine, 401 N. Broadway, 2242, 21231, Weinberg, Baltimore, MD, USA.
| | - Jeffrey Gagan
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Gao XJ, Peng XL, Wang YJ, He WM. Orbital solitary fibrous tumours: clinicopathological characteristics and recurrence prediction. Graefes Arch Clin Exp Ophthalmol 2023; 261:223-231. [PMID: 36029306 DOI: 10.1007/s00417-022-05795-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/14/2022] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND SFTs are thought to have an unpredictable clinical course and currently have no recognized prognostic criterion. Our study aimed to determine the relationship between clinicopathological characteristics and the prognosis of patients with orbital SFTs. METHODS The clinicopathological features of these patients were extracted from clinical records. The relationships between these features and prognosis were analysed. RESULTS The positive rates of CD34, CD99, Blc2, and STAT6 expression were 90.3%, 90.3%, 83.9%, and 100%, respectively. The tumour recurrence rate was 38.7%. A higher recurrence rate was observed in patients with Ki67 index ≥ 5 (56.25% vs. 20%, P = 0.038). CONCLUSION A Ki67 index ≥ 5 was an effective parameter for predicting tumour recurrence of orbital SFTs. Close follow-up is needed for these patients.
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Affiliation(s)
- Xiao-Jin Gao
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China.,Department of Ophthalmology, Chengdu First People's Hospital, Chengdu, China
| | - Xiao-Lin Peng
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu-Jiao Wang
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China
| | - Wei-Min He
- Department of Ophthalmology, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China.
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Rottmann D, Abdulfatah E, Pantanowitz L. Molecular testing of soft tissue tumors. Diagn Cytopathol 2023; 51:12-25. [PMID: 35808975 PMCID: PMC10084007 DOI: 10.1002/dc.25013] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/27/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The diagnosis of soft tissue tumors is challenging, especially when the evaluable material procured is limited. As a result, diagnostic ancillary testing is frequently needed. Moreover, there is a trend in soft tissue pathology toward increasing use of molecular results for tumor classification and prognostication. Hence, diagnosing newer tumor entities such as CIC-rearranged sarcoma explicitly requires molecular testing. Molecular testing can be accomplished by in situ hybridization, polymerase chain reaction, as well as next generation sequencing, and more recently such testing can even be accomplished leveraging an immunohistochemical proxy. CONCLUSION This review evaluates the role of different molecular tests in characterizing soft tissue tumors belonging to various cytomorphologic categories that have been sampled by small biopsy and cytologic techniques.
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Affiliation(s)
- Douglas Rottmann
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Eman Abdulfatah
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Liron Pantanowitz
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Wu H, Hu X, Xiang W, Liu N, Fang S, Xu T, Qi Y, Zheng L, Cai W, Wu C, Yu H. A Large Solitary Fibrous Tumor of the Nasal Cavity and Paranasal Sinuses Involving the Anterior Frontal Fossa: A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2022:1455613221113809. [PMID: 35848410 DOI: 10.1177/01455613221113809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The Solitary Fibrous Tumor (SFT) is a rare mesenchymal neoplasm that arises mainly from the pleura. The sinonasal tract is generally not affected by SFT, and less than 100 cases have been reported in the English literature to date. We report an extremely rare SFT of the nasal cavity and paranasal sinuses extending into the anterior frontal fossa through the floor of the anterior skull base. To our knowledge, this case is the fourth SFT of the sinonasal tract involving the anterior frontal fossa in the world. Meanwhile, the tumor, measuring 13 × 6 cm in images, is the largest SFT of the sinonasal tract compared to previously reported cases. Three surgical procedures, including a transcranial one, were performed for the patient to achieve complete removal of the tumor. The diagnosis of SFT was established primarily by immunohistochemical positivity for CD34, STAT6, and negativity for S-100 protein. We emphasize the possibility of recurrence in SFT, and close follow-up is necessary with the help of nasal endoscopy and imaging approaches.
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Affiliation(s)
- Huachao Wu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaoyan Hu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wenbin Xiang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Nuomin Liu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Sha Fang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ting Xu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Qi
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Linhui Zheng
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wenqi Cai
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chaoyan Wu
- Department of Traditional Chinese Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Haijun Yu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
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Kazazian K, Demicco EG, de Perrot M, Strauss D, Swallow CJ. Toward Better Understanding and Management of Solitary Fibrous Tumor. Surg Oncol Clin N Am 2022; 31:459-483. [PMID: 35715145 DOI: 10.1016/j.soc.2022.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Solitary fibrous tumor (SFT) comprises a histologic spectrum of soft tissue neoplasms that are characterized by the unique NAB2-STAT6 gene fusion. Changes in diagnostic terminology and site-specific classification over the past few decades have resulted in a disjointed literature. Complete surgical excision with preservation of function remains the mainstay of treatment. New risk stratification systems including risk factors such as mitotic rate, age, tumor size, and presence of necrosis, among others, can be used to predict risk of recurrence or metastasis. Long-term follow-up after surgical resection is recommended. The clinical manifestations, diagnosis, management, and prognosis of SFT are reviewed here.
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Affiliation(s)
| | - Elizabeth G Demicco
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Marc de Perrot
- Department of Surgery, University of Toronto, Toronto, Canada; Division of Thoracic Surgery, Princess Margaret Cancer Centre/University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G2C4, Canada
| | - Dirk Strauss
- Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust, Fulham Road, London SW3 6JJ, England
| | - Carol J Swallow
- Department of Surgery, University of Toronto, Toronto, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto, Canada.
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Rao V, Rekhi B, Abraham LK, Bapat P. A Rare Case of a Solitary Fibrous Tumor in a Child, Presenting as a Congenital Mass, Displaying NAB2ex4::STAT6ex2 Gene Fusion with an Incidental Ganglioneuroblastoma. Int J Surg Pathol 2022; 31:321-331. [PMID: 35711164 DOI: 10.1177/10668969221102543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A solitary fibrous tumor (SFT) is a ubiquitous tumor that occurs across all ages. It is rarely reported in pediatric patients, especially as a congenital mass. A 1 year 7-month old male child presented with a slow-growing gluteal mass since birth along with a recent episode of bleeding. Magnetic resonance imaging (MRI) showed a well-defined, T1-hypointense and T2-hyperintense mass in the skin and the subcutaneous plane. Subsequently, he underwent a surgical resection that revealed a 5.7 cm-sized fleshy mass. On histopathologic examination, there was a fairly well-circumscribed, cellular spindle cell tumor, with cells arranged in intersecting fascicles and hemangiopericytomatous pattern with areas of hemorrhage and fibrinoid necrosis. Cells revealed mild nuclear atypia. Mitotic figures were up to 8/10 hpf. Immunohistochemically, the tumor cells were diffusely positive for CD34 and STAT6. Furthermore, the tumor revealed NAB2 exon 4:: STAT6 exon 2 fusion by RT-PCR and Sanger sequencing. Post-excision, during follow-up, the patient developed an adrenal mass that was histopathologically proven as a neuroblastic tumor, not further specified on biopsy and finally as ganglioneuroblastoma, intermixed type on excision. This constitutes one of the rare cases of SFT in a pediatric patient, presenting as a congenital mass, confirmed by STAT6 immunostaining and further, molecular testing. A review of literature of similar cases, including treatment-related implications, is presented.
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Affiliation(s)
- Vidya Rao
- Department of Surgical Pathology, 29436Tata Memorial Hospital (TMH), Narayana Health, Bengaluru, India
| | - Bharat Rekhi
- Department of Surgical Pathology, 221116Tata Memorial Hospital, Homi Bhabha National Institute (HBNI) University, Parel, Mumbai, Maharashtra, India.,Division of Molecular Pathology and Translational Medicine, Tata Memorial Hospital (TMH), Homi Bhabha National Institute (HBNI) University, Parel, Mumbai, Maharashtra, India
| | - Latha K Abraham
- Department of Pathology, 477833Rajagiri Hospital, Aluva, Kerala, India
| | - Prachi Bapat
- Division of Molecular Pathology and Translational Medicine, Tata Memorial Hospital (TMH), Homi Bhabha National Institute (HBNI) University, Parel, Mumbai, Maharashtra, India
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14
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Consolo U, Diamante F, Salgarelli AC, Bellini P. A rare case of solitary fibrous tumor of the temporal region: 7-year-follow-up clinical-radiographic evaluation and literature review. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2021.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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Alsaadi KA, Alwohaib M, Pinto K, Ali RH. Giant cell-rich solitary fibrous tumour of the lacrimal gland with prominent angiomatoid cystic changes and an underlying NAB2ex3-STAT6ex18 fusion. BMJ Case Rep 2022; 15:15/2/e247141. [PMID: 35185020 PMCID: PMC8860007 DOI: 10.1136/bcr-2021-247141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Giant cell-rich solitary fibrous tumour (GCR-SFT) is a rare variant of SFT with a predilection for the orbital region. Despite its hypervascularity, extensive angiomatoid cystic changes are unusual in GCR-SFT and may pose a diagnostic challenge. A 47-year-old man presented with a right eye proptosis and a protruding tumour of several years’ duration with recently accelerated tumour growth. MRI revealed a cystic-solid heterogeneous mass arising from the lacrimal gland and displacing the globe. A subtotal excision of the mass was performed due to unanticipated hypervascularity and intraoperative bleeding. Pathologically, a vascular neoplasm was initially suspected. The diagnosis of GCR-SFT was made following careful evaluation and demonstration of CD34 and STAT6 expression. Molecular studies revealed a pathognomonic but rare NAB2ex3-STAT6ex18 fusion variant as well as a TP53 mutation suggestive of aggressive phenotype. The patient had a complete resolution of the proptosis but the clinical picture remains guarded due to incomplete resection.
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Affiliation(s)
| | - Manar Alwohaib
- Al Bahar Eye Center, Ibn Sina Hospital, Shuwaikh, Kuwait
| | - Karen Pinto
- Department of Pathology, Kuwait Cancer Control Center, Shuwaikh, Kuwait
| | - Rola H Ali
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriyah, Kuwait
- Cytogenetics Laboratory, Kuwait Cancer Control Center, Shuwaikh, Kuwait
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16
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Negură I, Ianole V, Dănilă R, Ungureanu MC, Apostol DGC. Primary solitary fibrous tumor of the thyroid gland: A review starting from a case report. Arch Clin Cases 2022; 8:97-105. [PMID: 34984233 PMCID: PMC8717007 DOI: 10.22551/2021.33.0804.10193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Primary solitary fibrous tumor (SFT) of the thyroid gland is a rare mesenchymal tumor with fibroblastic differentiation, ramified, thin-walled, enlarged (staghorn) vessels and specific NAB2-STAT6 gene fusion, which is more commonly found in pleura and peritoneum. This neoplasm can be located in a variety of anatomical sites outside pleura and peritoneum including bone, visceral organs and soft tissues, head and neck examples representing only 10-15% of the extra-pleural and extra-peritoneal tumors. Diagnosing this entity can be difficult, especially in thyroid gland, mainly because of the rarity of this neoplasm, but presence of characteristic microscopic features together with positivity for STAT6 and CD34 can confirm the diagnosis and exclude other differential diagnosis. Information about the diagnosis and treatment options of thyroid SFTs is limited but almost all primary thyroid SFTs have a good prognosis and indolent clinical course. Clinical surveillance is still necessary because some SFTs can be aggressive. Raising awareness regarding extra-pleural and extra-peritoneal location of this tumor in endocrine organs can help to better manage these patients. We report the case of a 34-year-old female with primary SFT of the thyroid gland. Additionally, we review the literature for the main clinical, paraclinical and pathological features of this neoplasm.
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Affiliation(s)
- Ion Negură
- Pathology Department, "Sf. Spiridon" Emergency County Clinical Hospital, Iasi, Romania.,Pathology Department, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Victor Ianole
- Pathology Department, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Radu Dănilă
- Department of Surgery, III-rd Surgical Unit, "Sf. Spiridon" Emergency County Clinical Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Maria-Christina Ungureanu
- Endocrinology Department, "Sf. Spiridon" Emergency County Clinical Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Delia Gabriela Ciobanu Apostol
- Pathology Department, "Sf. Spiridon" Emergency County Clinical Hospital, Iasi, Romania.,Pathology Department, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
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17
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A Case Report of a Solitary Fibrous Tumor of the Maxillary Sinus. REPORTS 2021. [DOI: 10.3390/reports4040033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A solitary fibrous tumor (SFT) is a benign neoplasm, firstly described as a mesenchymal tumor of the pleura. Its incidence range in the head and neck region is about 5–27%, but only rarely does it affect paranasal sinuses. The differential diagnosis is challenging, owing to its erosive growth pattern and immuno-histochemical features. SFTs have an aggressive behavior and an important recurrence potential. Therefore, a radical surgical excision is the gold standard therapeutic procedure. A rare SFT originating from the right maxillary sinus is reported here. The 37-year-old patient presented to the outpatient clinic with a painful expansive lesion in the whole right maxillary region. The overlying skin was inflamed and the patient had no epistaxis episodes. The 1.5 dentary element tested negative for vitality; however, a puncture of the lesion led to a hematic spill and no purulent discharge. An endoscopic-guided biopsy was suggestive either of SFT or hemangioperictoma, excluding a malignant neoplasm. A multi-equipe surgical team was activated. The lesion was embolized in order to achieve a good hemostatic control and, after 48 h, the neoplasm was radically excised with a combined open and endoscopic approach. The patient was disease-free at 12-month radiological and clinical follow-up. Given the rarity of this lesion and the delicacy required in addressing head and neck neoplasms, we believe that the present case report might be of help in further understanding how to approach cranio-facial SFTs.
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18
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Karpathiou G, Papoudou-Bai A, Ferrand E, Dumollard JM, Peoc'h M. STAT6: A review of a signaling pathway implicated in various diseases with a special emphasis in its usefulness in pathology. Pathol Res Pract 2021; 223:153477. [PMID: 33991851 DOI: 10.1016/j.prp.2021.153477] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 12/17/2022]
Abstract
Signal Transducer and Activator of Transcription 6 (STAT6), belonging to a family of seven similar members is primarily stimulated by interleukin(IL)-4 and IL-13, and acts as a T helper type 2 (Th2)-inducing factor. Thus, it is implicated in the pathophysiology of various allergic conditions, such as asthma, atopic dermatitis, eosinophilic esophagitis and food allergies, but also in tumor microenvironment regulation. Furthermore, certain forms of lymphomas, notably the Hodgkin lymphoma group, the primary mediastinal and primary central nervous system lymphoma, as well as some follicular and T cell lymphomas are associated with dysregulation of the STAT6 pathway. STAT6 immunohistochemical expression also serves as a surrogate marker in the diagnosis of solitary fibrous tumor, despite not directly responsible for the tumorigenic effect. These pathophysiological implications of the STAT6 pathway, its diagnostic or prognostic role in pathology, as well its immunohistochemical detection with different antibodies will be discussed in this review.
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Affiliation(s)
| | | | - Elise Ferrand
- Pathology Department, University Hospital of Saint-Etienne, France
| | | | - Michel Peoc'h
- Pathology Department, University Hospital of Saint-Etienne, France
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19
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Lipomatous Solitary Fibrous Tumors Harbor Rare NAB2-STAT6 Fusion Variants and Show Up-Regulation of the Gene PPARG, Encoding for a Regulator of Adipocyte Differentiation. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:1314-1324. [PMID: 33887215 DOI: 10.1016/j.ajpath.2021.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 12/27/2022]
Abstract
Solitary fibrous tumors (SFTs) harbor activating NAB2-STAT6 gene fusions. Different variants of the NAB2-STAT6 gene fusion have been associated with distinct clinicopathologic features. Lipomatous SFTs are a morphologic variant of SFTs, characterized by a fat-forming tumor component. Our aim was to evaluate NAB2-STAT6 fusion variants and to further study the molecular genetic features in a cohort of lipomatous SFTs. A hybrid-capture-based next-generation sequencing panel was employed to detect NAB2-STAT6 gene fusions at the RNA level. In addition, the RNA expression levels of 507 genes were evaluated using this panel, and were compared with a control cohort of nonlipomatous SFTs. Notably, 5 of 11 (45%) of lipomatous SFTs in the current series harbored the uncommon NAB2 exon 4-STAT6 exon 4 gene fusion variant, which is observed in only 0.9% to 1.4% of nonlipomatous SFTs. Furthermore, lipomatous SFTs displayed significant differences in gene expression compared with their nonlipomatous counterparts, including up-regulation of the gene peroxisome proliferator activated receptor-γ (PPARG). Peroxisome proliferator activated receptor-γ is a nuclear receptor regulating adipocyte differentiation, providing a possible explanation for the fat-forming component in lipomatous SFTs. In summary, the current study provides a possible molecular genetic basis for the distinct morphologic features of lipomatous SFTs.
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20
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Affiliation(s)
- C A Righini
- CHU de Grenoble Alpes (CHUGA), 38043 Grenoble cedex 09, France; Faculté de médecine Grenoble Alpes, 38700 La Tronche, France; Unité Inserm UJF/U823, Centre de Recherche Albert Bonniot, 38043 Grenoble cedex 09, France.
| | - H Gil
- CHU de Grenoble Alpes (CHUGA), 38043 Grenoble cedex 09, France
| | - C Fabre
- CHU de Grenoble Alpes (CHUGA), 38043 Grenoble cedex 09, France; Faculté de médecine Grenoble Alpes, 38700 La Tronche, France
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21
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Giant Cell Angiofibroma in Sublingual Area: A Case Report and Review of Literature. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021; 55:134-137. [PMID: 33935548 PMCID: PMC8085454 DOI: 10.14744/semb.2019.55452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 10/04/2019] [Indexed: 11/20/2022]
Abstract
We present a case of Giant Cell-Rich Solitary Fibrous Tumor also known as Giant cell angiofibroma, occuring in sublingual region, to our knowledge, which has never been reported before. Forty-nine years old female who presented with painless, slowly growing mass in the sublingual region underwent excisional surgery and was diagnosed with giant cell-rich solitary fibrous tumor previously referred to as giant cell angiofibroma. In our report, we aimed to report the unusual localization of this rare tumor, examine the new nomenclature and classification of giant cell-rich solitary sibrous tumor or giant cell angiofibroma and review the literature regarding head and neck localization of this tumor.
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22
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Shmuly T, Ben Zvi Y, Chaushu G, Kaplan I. Oral Solitary Fibrous Tumor: A Retrospective Clinico-Pathological Study and Long-Term Follow-Up. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:152. [PMID: 33567630 PMCID: PMC7914433 DOI: 10.3390/medicina57020152] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 12/16/2022]
Abstract
Background and Objectives: This was a retrospective single-center study to analyze and describe the clinical and histological features of all cases of oral solitary fibrous tumor (SFT). Study design: the study included all consecutive cases of oral SFT diagnosed between 2008-2018 at a single tertiary center. Materials and Methods: Clinical data was retrieved from medical charts. The diagnosis of oral SFT was based upon the morphologic features of the lesions, in routine hematoxylin and eosin (H&E) stained sections and confirmed by immunohistochemical analyses including CD34, CD99, Bcl2, and stains for STAT6. Results: Seven cases of oral SFT were found. Of these, three (42%) were in males and four (58%) in females. The age range was 24-63 years (mean 47 ± 13). Four (58%) lesions were located in the buccal mucosa, two (28%) in the labial mucosa and one (14%) on the floor of the mouth. The diameter ranged between 3-50 mm (mean 22 ± 14 mm). All patients were treated with local excision. Follow-up periods were between 2-74 months (mean 41 ± 27). No recurrences were reported. Conclusions: We present a series of oral SFT, which were all non-aggressive in presentation and did not recur after conservative surgery (local excision) over a relatively long follow-up period.
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Affiliation(s)
- Tom Shmuly
- Oral and Maxillofacial Surgery Department, Kaplan Medical Center, Rehovot 7642001, Israel
- Oral and Maxillofacial Surgery Department, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel;
| | - Yehonatan Ben Zvi
- Oral and Maxillofacial Surgery Department, Rabin Medical Center, Petah-Tikva 4941492, Israel;
| | - Gabriel Chaushu
- Oral and Maxillofacial Surgery Department, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel;
- Oral and Maxillofacial Surgery Department, Rabin Medical Center, Petah-Tikva 4941492, Israel;
| | - Ilana Kaplan
- Pathology Department, Rabin Medical Center, Petah-Tikva 4941492, Israel;
- Oral Pathology Department, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel
- Pathology Department, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6934206, Israel
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23
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Kaoutar C, Ahmedou AB, Omar B, Anas B, Oukessou Y, Abada R, Sami R, Mohamed R, Mohamed M, Meriem R, Mehdi K. Endoscopic resection of solitary fibrous tumor of the ethmoid: Case report review of the literature. Ann Med Surg (Lond) 2020; 60:714-718. [PMID: 33425340 PMCID: PMC7779965 DOI: 10.1016/j.amsu.2020.11.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Solitary fibrous tumour (SFT), as are benign neoplasms of fibroblastic cells. Nasosinusal localisation is exremely rare, difficult to diagnose and to manage. CASE REPORT We report a rare case of Solitary fibrous tumour in the nasal cavity in a 47-year-old- woman, with complete surgical resection. DISCUSSION SFTs are of mesenchymal origin, mainly from serous membranes. The head and neck region is affected with a percentage ranging from 5 to 27%. On the other hand, LTS unusually affects the nasal tract (NTS). Because of this rarity and its variable morphological appearance, it is difficult to distinguish TNS from other mesenchymal lesions. CONCLUSION Although there are no standard clinical guidelines, the preferred treatment for FLS is radical surgical resection.
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Affiliation(s)
- Chaker Kaoutar
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Ahmed Brahim Ahmedou
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Berrada Omar
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Bouzbouz Anas
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Youssef Oukessou
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Redallah Abada
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Rouadi Sami
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Roubal Mohamed
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Mahtar Mohamed
- ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Regragui Meriem
- Pathology Department, Centre IBN ROCHD, Casablanca, Kingdom of Morocco
| | - Karkouri Mehdi
- Pathology Department, Centre IBN ROCHD, Casablanca, Kingdom of Morocco
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Thompson LDR, Liou SS, Feldman KA. Orbit Solitary Fibrous Tumor: A Proposed Risk Prediction Model Based on a Case Series and Comprehensive Literature Review. Head Neck Pathol 2020; 15:138-152. [PMID: 32529350 PMCID: PMC8010011 DOI: 10.1007/s12105-020-01184-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
Solitary fibrous tumors (SFTs) of the orbit are rare. In order to further characterize the clinical and pathologic features of solitary fibrous tumor arising at this anatomic site, 12 cases of orbital SFTs were analyzed in conjunction with a review of 263 cases reported from the English literature in order to develop a risk prediction model. SFTs of the orbit were equally distributed between males (n = 5) and females (n = 7) with a mean patient age of 46.8 years (median 44.5 years; range 18-76 years) at initial diagnosis. The patients typically presented with swelling or mass around the orbit, with proptosis (n = 10), ptosis (n = 5), and visual changes (n = 6). Tumors were orbital (n = 10) or upper eyelid (n = 2). Mean tumor size was 2.5 cm (median 2.6 cm). Microscopically, the tumors were characterized by cytologically bland spindle cells with patternless growth, hypocellular and hypercellular areas, variable amounts of collagen, and ectatic, branching blood vessels. By immunohistochemistry, all cases had a strong nuclear STAT6 expression. All patients were initially managed with excision or biopsy, three with presurgical embolization. The two patients with biopsy only had persistent disease (mean 37.2 months), but a third patient developed distant bone metastasis at 86.9 months. Overall mean follow-up was 73.1 months: 9 patients are alive or dead without disease (mean 77.9 months), two patients with persistent disease, and one patient with metastatic disease at last follow-up (102 months). Incorporating cases sufficiently reported in the literature, a risk prediction model based on age > 45 years, tumor size > 3 cm, tumor necrosis, mitoses of > 4/2 mm2, moderate to high cellularity, and moderate to severe pleomorphism allows for risk stratification for the development of local recurrence and distant metastasis. In conclusion, orbital SFTs are rare, but can be reliably diagnosed based on the presence of characteristic morphologic features and STAT6 immunohistochemistry. Orbital tumors tend to show a higher frequency of local recurrence than distant metastasis, which can be predicted by a risk stratification model unique to orbital tumors. With late disease common, long term clinical follow-up is recommended.
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Affiliation(s)
- Lester D. R. Thompson
- Department of Pathology, Southern California Permanente Medical Group, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| | - Sofia S. Liou
- Department of Pathology, University of California: Los Angeles, Los Angeles, CA USA
| | - Kenneth A. Feldman
- Department of Ophthalmology, Southern California Permanente Medical Group, Harbor City, CA USA
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25
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de Morais EF, Martins HDD, Rodrigues KS, de França GM, da Silveira ÉJD, Freitas RDA. Clinicopathologic Analysis of Oral and Maxillofacial Solitary Fibrous Tumor. Am J Clin Pathol 2020; 154:15-22. [PMID: 32134474 DOI: 10.1093/ajcp/aqaa027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The aim of this systematic review was to provide an overview of the oral and maxillofacial solitary fibrous tumor (SFT) in order to determine its clinicopathologic characteristics and biological behavior. METHODS We conducted a systematic review in May 2019 in multiple databases. Cases diagnosed as SFT in the oral cavity and maxillofacial complex were included. RESULTS Seventy-three published articles were included in our systematic review, corresponding to a total of 154 cases. SFT showed a slight female predilection (53.2%), and the cheek mucosa/cheek, tongue, and palate were the most affected anatomical sites. The mean size of SFT in the oral cavity and maxillofacial region at diagnosis was 1.4 cm. Histologic features of malignancy by morphologic analysis (P < .001) were significantly associated with a larger tumor size. Surgical excision was the most frequent therapeutic modality. Recurrence and metastasis were uncommon findings in our sample. CONCLUSIONS Histologic features of malignancy can be important parameters of tumor behavior. Adequate surgical treatment and long-term follow-up are required for these cases.
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26
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Alkatan HM, Alsalamah AK, Almizel A, Alshomar KM, Maktabi AM, ElKhamary SM, Eberhart CG, Iuliano A, Lanni V, Strianese D. Orbital solitary fibrous tumors: a multi-centered histopathological and immunohistochemical analysis with radiological description. Ann Saudi Med 2020; 40:227-233. [PMID: 32493043 PMCID: PMC7270616 DOI: 10.5144/0256-4947.2020.227] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFT), formerly called hemangiopericytoma, are rare tumors derived from mesenchymal cells originally described in the pleura, but these tumors may affect extraserosal tissues including the lacrimal gland and orbit. OBJECTIVE Conduct a multi-centered clinical, radiological and histopathological analysis of 17 orbital SFT cases. DESIGN A retrospective case series. SETTING Three eye centers in two countries. PATIENTS AND METHODS The data collected from the charts of 17 adult patients presenting with tissue diagnosis of orbital hemangiopericytoma or SFT from January 2003 to December 2018 included demographics, clinical imaging and histopathological information including immunohistochemical (IHC) characteristics. MAIN OUTCOME MEASURES The demographic characteristics, clinical presentation, and histopathological patterns or variants of SFT were analyzed. SAMPLE SIZE 17 adult patients. RESULTS Mean age was 45 years (range 23-80 years). Male to female ratio was 3:1. The right eye was affected in 12 (70.5%) patients. Commonest presentation was proptosis in 13/17 (76% of patients). Other symptoms were impaired motility (29%) and ptosis (11%). Lesions mostly affected the medial orbit (35%), then orbital apex in 11%. The histopathological classic pattern-less variant was the commonest. One case with aggressive behavior, multiple recurrences and atypical features was encountered. Immunohistochemical (IHC) markers used included CD34 expression in all cases, Bcl-2 expression in 10/11, CD99 in 9/9 and Vimentin in 4/4. STAT6 was used in 2 cases. CONCLUSIONS SFTs are rare tumors affecting the orbit in both genders equally in their mid-forties, but showed male predominance in our analysis with a predominant classic histopathological pattern. Tissue diagnosis is essential and requires IHC studies for confirmation. LIMITATIONS Sample size is relatively small owing to the rarity of this tumor in the orbit. CONFLICT OF INTEREST None.
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Affiliation(s)
- Hind Manaa Alkatan
- From the Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia
| | - Abrar K Alsalamah
- From the Division of Vitreoretinal and Uveitis, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Khalid M Alshomar
- From the Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia
| | - Azza My Maktabi
- From the Department of Pathology and Laboratory Medicine, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Sahar M ElKhamary
- From the Department of Radiology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Charles G Eberhart
- From the Department of Pathology, Ophthalmology and Oncology, John Hopkins University, School of Medicine, Baltimore, United States
| | - Adriana Iuliano
- From the Department of Neuroscience, School of Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Vittoria Lanni
- From the Department of Neuroscience, School of Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Diego Strianese
- From the Department of Neuroscience, School of Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.,From the Orbital Unit, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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27
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Solitary fibrous tumors of the head and neck region revisited: a single-institution study of 20 cases and review of the literature. Hum Pathol 2020; 99:1-12. [PMID: 32217090 DOI: 10.1016/j.humpath.2020.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/07/2020] [Accepted: 03/16/2020] [Indexed: 01/18/2023]
Abstract
A solitary fibrous tumor (SFT) is a rare, NAB2-STAT6 fusion gene-associated mesenchymal neoplasm. It most commonly arises in the pleural site, but it can occur at many other sites, and rarely also in the head and neck (H&N) region. STFs may show many growth patterns and therefore can be easily mistaken for other more common H&N spindle cell or epithelial lesions. In this study, we present our experience in the diagnosis of 20 cases of SFT in the H&N region and discuss their most notable mimickers. In all cases, STAT6 expression was found positive by immunohistochemistry, and the NAB2-STAT6 fusion was confirmed by next-generation sequencing. Three major fusion variants were detected: NAB2ex2-STAT6int1 (5/20, 25%), NAB2ex6-STAT6ex16 (4/20, 20%), and NAB2ex4-STAT6ex2 (3/20, 15%). Clinical follow-up was available for 16 patients (median follow-up time: 84 months). One patient with a morphologically malignant SFT experienced multiple local recurrences, followed by dissemination into the lungs and meninges. This malignant SFT also displayed an aberrant FLI1 expression, which was not previously reported in SFT cases. We also summarize findings from 200 cases of SFT of the H&N region, which included cases from our study, and from previous studies that reported on the fusion status of the STAT6 gene. The results suggest that metastatic disease developed only in cases with STAT6 variants that included the DNA-binding domain (STAT6-full variants), which contradicts expectations from previous reports and deserves further investigation.
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28
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Soft Tissue Special Issue: Fibroblastic and Myofibroblastic Neoplasms of the Head and Neck. Head Neck Pathol 2020; 14:43-58. [PMID: 31950474 PMCID: PMC7021862 DOI: 10.1007/s12105-019-01104-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022]
Abstract
Fibroblastic and myofibroblastic neoplasms of the head and neck encompass a group of rare tumor types with often overlapping clinicopathologic features that range in biologic potential from benign to overtly malignant. Even neoplasms with no metastatic potential may provide significant therapeutic challenges in this region due to the unique anatomy of the head and neck. This review will cover the following entities, highlighting important clinical aspects of each neoplasm and then focusing on their characteristic histomorphology, immunophenotype, and molecular alterations: nodular and cranial fasciitis, fibrous hamartoma of infancy, nasopharyngeal angiofibroma, nuchal-type and Gardner fibromas, desmoid fibromatosis, dermatofibrosarcoma protuberans and giant cell fibroblastoma, solitary fibrous tumor, inflammatory myofibroblastic tumor, low-grade myofibroblastic sarcoma, infantile fibrosarcoma, low-grade fibromyxoid sarcoma, and sclerosing epithelioid fibrosarcoma. While some of these neoplasms characteristically arise in the head and neck, others are rarely described in this anatomic region and may therefore be particularly difficult to recognize. Distinction between these entities, however, is crucial, particularly as the molecular pathogenetic basis for these neoplasms are being rapidly elucidated, in some instances allowing for targeted therapeutic approaches.
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29
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Nunes FB, Sant'Ana MSP, Silva AMB, Agostini M, Silva Canedo NH, Andrade BAB, Romañach MJ, Corrêa DL, Tomasi RA, Radhakrishnan R, Gomez RS, Sousa SF, Brennan PA, Fonseca FP. Solitary fibrous tumour of the oral cavity: An update. J Oral Pathol Med 2019; 49:14-20. [DOI: 10.1111/jop.12953] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Fernanda Bispo Nunes
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Maria Sissa Pereira Sant'Ana
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - André Myller Barbosa Silva
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology School of Dentistry Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | | | | | - Mário José Romañach
- Department of Oral Diagnosis and Pathology School of Dentistry Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | | | - Ramiro Alejandro Tomasi
- Department of Oral Pathology Dental School Universidad Nacional de Córdoba Córdoba Argentina
| | - Raghu Radhakrishnan
- Department of Oral Pathology Manipal College of Dental Sciences Manipal Academy of Higher Education (MAHE) Manipal India
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Silvia Ferreira Sousa
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Peter A. Brennan
- Department of Oral and Maxillofacial Surgery Queen Alexandra Hospital Portsmouth UK
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
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30
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Stanisce L, Ahmad N, Levin K, Deckard N, Enriquez M, Brody J, Koshkareva Y. Solitary Fibrous Tumors in the Head and Neck: Comprehensive Review and Analysis. Head Neck Pathol 2019; 14:516-524. [PMID: 31338745 PMCID: PMC7235103 DOI: 10.1007/s12105-019-01058-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 07/19/2019] [Indexed: 11/29/2022]
Abstract
Solitary fibrous tumors (SFT) arising in the head and neck region are uncommon yet well-recognized entities. Their biologic behavior and management still need to be elucidated. Systematically reviewing all published cases of SFT involving the head and neck region since 1991, a pooled meta-analysis was conducted to evaluate various demographic and tumor characteristics. 587 SFT in the head and neck have been reported; 343 met pooled analysis inclusion criteria. 61% of cases presented as a new mass; 89% were painless. Median onset of symptoms prior to evaluation was 8 months. Pre-operative local invasion and malignant histological features (hemorrhage, necrosis, mitoses > 4/10 hpf) were not statistically associated with decreased recurrence-free survival. Positive surgical margins was the only factor associated with shorter recurrence-free survival (p < 0.001). The evidence presented herein reveals novel associations between clinical presentation and tumor characteristics that provide otolaryngologists with new insight into SFT tumor behavior, thus prompting further investigations.
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Affiliation(s)
- Luke Stanisce
- Division of Otolaryngology – Head and Neck Surgery, Cooper University Health Care, Camden, NJ USA ,Cooper Medical School of Rowan University, Camden, NJ USA ,Division of Otolaryngology – Head and Neck Surgery, Cooper University Health Care, Three Cooper Plaza, Suite 411, Camden, NJ 08103 USA
| | - Nadir Ahmad
- Division of Otolaryngology – Head and Neck Surgery, Cooper University Health Care, Camden, NJ USA ,Cooper Medical School of Rowan University, Camden, NJ USA ,MD Anderson Cancer Center at Cooper, Head and Neck Cancer Center, Camden, NJ USA
| | - Kristin Levin
- Department of Otolaryngology – Head and Neck Surgery and Communicative Disorders, University of Louisville, Louisville, KY USA
| | - Nathan Deckard
- Division of Otolaryngology – Head and Neck Surgery, Cooper University Health Care, Camden, NJ USA ,Cooper Medical School of Rowan University, Camden, NJ USA
| | - Miriam Enriquez
- Cooper Medical School of Rowan University, Camden, NJ USA ,Department of Pathology, Cooper University Health Care, Camden, NJ USA
| | - Joshua Brody
- Cooper Medical School of Rowan University, Camden, NJ USA ,Department of Radiology, Cooper University Health Care, Camden, NJ USA
| | - Yekaterina Koshkareva
- Division of Otolaryngology – Head and Neck Surgery, Cooper University Health Care, Camden, NJ USA ,Cooper Medical School of Rowan University, Camden, NJ USA ,MD Anderson Cancer Center at Cooper, Head and Neck Cancer Center, Camden, NJ USA
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31
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Park HK, Yu DB, Sung M, Oh E, Kim M, Song JY, Lee MS, Jung K, Noh KW, An S, Song K, Nam DH, Kim YJ, Choi YL. Molecular changes in solitary fibrous tumor progression. J Mol Med (Berl) 2019; 97:1413-1425. [PMID: 31321477 PMCID: PMC6746689 DOI: 10.1007/s00109-019-01815-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/28/2019] [Accepted: 06/18/2019] [Indexed: 12/14/2022]
Abstract
Abstract Solitary fibrous tumors (SFTs) are NAB2-STAT6 fusion-associated neoplasms. There are several subtypes of NAB2-STAT6 fusions, but their clinical significances are still unclear. Moreover, the mechanisms of malignant progression are also poorly understood. In this study, using 91 SFT cases, we examined whether fusion variants are associated with clinicopathological parameters and also investigated the molecular mechanism of malignant transformation using whole-exome sequencing. We detected variant 1b (NAB2ex4-STAT6ex2) in 51/91 (56%) cases and variants 2a/2b (NAB2ex6-STAT6ex16/17) in 17/91 (19%) cases. The NAB2-STAT6 fusion variant types were significantly associated with their primary site (P < 0.001). In addition, a TERT promoter mutation was detected in 7/73 (10%) cases, and it showed a significant association with malignant SFTs (P = 0.003). To identify molecular changes during malignant progression, we selected an index patient to obtain parallel tissue samples from the primary and metastatic tumors. In the metastatic tissue, 10 unique molecular alterations, including those in TP53 and APAF1, were detected. In vitro functional experiments showed that APAF1 depletion increased the tumor potency of cells expressing NAB2-STAT6 fusion protein under treatment with staurosporine. We found that TP53 immunopositivity (P = 0.006) and loss of APAF1 immunoreactivity (P < 0.001) were significantly associated with malignant SFTs. Our study suggests that dysfunction of TP53 and APAF1 leads to impaired apoptotic function, and eventually contributes toward malignant SFT transformation. Key messages We firstly found that the TERT promoter mutation was strongly associated with malignant SFTs (P = 0.003) and the representative 1b (NAB2ex4-STAT6ex2) or 2a (NAB2ex6-STAT6ex16) fusion variants similarly contribute to tumorigenicity. We also found that TP53 immunopositivity (P = 0.006) and loss of APAF1 immunoreactivity (P < 0.001) were significantly associated with malignant SFTs. Our study suggests that dysfunction of TP53 and APAF1 leads to impaired apoptotic function, and eventually contributes toward malignant SFT transformation.
Electronic supplementary material The online version of this article (10.1007/s00109-019-01815-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hyung Kyu Park
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Dan Bi Yu
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Minjung Sung
- Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Ensel Oh
- Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Mingi Kim
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Ji-Young Song
- Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Mi-Sook Lee
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Kyungsoo Jung
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Ka-Won Noh
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Sungbin An
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Kyoung Song
- The Center for Companion Diagnostics, LOGONE Bio Convergence Research Foundation, Seoul, South Korea
| | - Do-Hyun Nam
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Yu Jin Kim
- Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea.
| | - Yoon-La Choi
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea. .,Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea. .,Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea.
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32
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Thompson LDR, Wei C, Rooper LM, Lau SK. Thyroid Gland Solitary Fibrous Tumor: Report of 3 Cases and a Comprehensive Review of the Literature. Head Neck Pathol 2019; 13:597-605. [PMID: 30758754 PMCID: PMC6854167 DOI: 10.1007/s12105-019-01012-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 01/14/2019] [Indexed: 02/07/2023]
Abstract
Solitary fibrous tumors of the thyroid gland are exceptionally rare. In order to further characterize the clinical and pathologic features of solitary fibrous tumor arising at this anatomic site, three cases of thyroid gland solitary fibrous tumor were analyzed in conjunction with 35 cases compiled from the English literature. Thyroid gland solitary fibrous tumors showed an equal sex distribution with a mean age at presentation of 54.4 years (range, 28-88 years). The patients typically presented with an asymptomatic, slow growing neck mass. Microscopically, the tumors were characterized by cytologically bland spindle cells with patternless growth, hypocellular and hypercellular areas, variable amounts of collagen, and ectatic, branching blood vessels. Two previous reported tumors were considered to be histologically malignant on the basis of increased mitotic activity, profound pleomorphism and tumor necrosis. Immunohistochemically, the tumor cells are variably positive with CD34, bcl-2, and CD99. STAT6 immunohistochemistry, performed on the current cases, demonstrated a strong, diffuse nuclear expression in all tumors. Among 26 patients with available follow up data (mean 47.3 months), one developed local recurrence and distant metastasis. Solitary fibrous tumors occurring in the thyroid gland are uncommon, but can be reliably diagnosed based on the presence of characteristic morphologic features as well as immunohistochemical expression of STAT6 and CD34. The majority of thyroid gland solitary fibrous tumors have exhibited an indolent clinical course, however experience is limited. The rare potential for aggressive clinical behavior requires clinical surveillance.
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Affiliation(s)
- Lester D. R. Thompson
- Southern California Permanente Medical Group, Department of Pathology, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, Los Angeles, CA 91365 US
| | - Christina Wei
- Southern California Permanente Medical Group, Department of Pathology, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, Los Angeles, CA 91365 US
| | - Lisa M. Rooper
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD US
| | - Sean K. Lau
- Southern California Permanente Medical Group, Department of Pathology, Orange County-Anaheim Medical Center, Anaheim, CA US
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33
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Recurrent Sinonasal CD34-Negative Malignant Solitary Fibrous Tumor Diagnosed on STAT6 Immunohistochemistry and NAB2-STAT6 Fusion. Head Neck Pathol 2019; 14:250-256. [PMID: 30623305 PMCID: PMC7021867 DOI: 10.1007/s12105-018-00999-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/31/2018] [Indexed: 12/16/2022]
Abstract
A spectrum of mesenchymal neoplasms occur in the sinonasal region. One of these is solitary fibrous tumor (SFT), a translocation-associated neoplasm characterized by NAB2-STAT6 gene fusion. Sinonasal SFTs characteristically display CD34 immunopositivity, which aids in diagnosis. However, a small proportion of SFTs may be negative for CD34, making diagnosis difficult. The availability of STAT6 immunohistochemistry (IHC) has helped to overcome this. Malignant SFTs, characterized by increased cellularity and mitoses > 4 per ten high power fields, are extremely unusual in the sinonasal region, with only ten such cases reported to date. We report a case of a CD34-negative malignant SFT that was diagnosed using STAT6 IHC and confirmed by demonstrating NAB2 ex 4-STAT6 ex 2 fusion, and recurred 8 months after complete excision, to highlight the aggressive nature of this tumor.
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34
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Cox J, Armstrong JE, Pandey S, Wehrli B, Chan KC, McCord C. Enlarging growth of the mental region in a 48-year-old man. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 128:191-198. [PMID: 30122440 DOI: 10.1016/j.oooo.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/18/2018] [Accepted: 07/02/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Jacqueline Cox
- Department of Dentistry, London Health Sciences Centre, London, Ontario, Canada; Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jerrold E Armstrong
- Department of Dentistry, London Health Sciences Centre, London, Ontario, Canada; Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sachin Pandey
- Department of Medical Imaging, London Health Sciences Centre and Western University, London, Ontario, Canada
| | - Bret Wehrli
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - King Chong Chan
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | - Christina McCord
- Department of Dentistry, London Health Sciences Centre, London, Ontario, Canada; Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada; Division of Oral pathology, Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
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35
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Yammine K, Nasser HA, Hadi U, Natout MA, Najjar V, Tayar C. Salvage preoperative embolization of an infratemporal solitary fibrous tumor: A case report with review of the literature. Medicine (Baltimore) 2018; 97:e0251. [PMID: 29595682 PMCID: PMC5895367 DOI: 10.1097/md.0000000000010251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Head and Neck Solitary fibrous tumors (SFT) are very rare. They could be misdiagnosed as hemangiopericytomas (HPC). PATIENT CONCERNS We report a 60 y o lady presenting with sinonasal mass, causing recurrent profuse bleeding. DIAGNOSES Hemangioperocytomas versus SFT were among the differentials, according to Radiological studies. Upon Biopsy, the diagnosis of SFT has been adopted. INTERVENTIONS Salvage pre-operative embolization resulted in bleeding control, bridging the patient to surgery. OUTCOMES Post-operative course was uneventful, and patient symptoms resolved. LESSONS This is the first case report of a sinonasal SFT, where pre-operative embolization has been employed as a salvage procedure. This treatment modality is promising, since it controls bleeding, bridges patient to surgery and decreases blood loss during the surgical procedure.
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Affiliation(s)
- Kabalane Yammine
- Department of Diagnostic and interventional radiology, Clemenceau Medical Center
| | - Haydar A. Nasser
- Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Haddath
| | | | | | | | - Claude Tayar
- Department of Digestive and General Surgery, Clemenceau Medical Center, Beirut, Lebanon
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36
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Roberts F, MacDuff E. An update on mesenchymal tumours of the orbit with an emphasis on the value of molecular/cytogenetic testing. Saudi J Ophthalmol 2018; 32:3-12. [PMID: 29755264 PMCID: PMC5944000 DOI: 10.1016/j.sjopt.2018.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/08/2018] [Accepted: 02/11/2018] [Indexed: 02/07/2023] Open
Abstract
Mesenchymal tumours of the orbit are uncommon. Beyond childhood primary sarcomas are extremely rare and the literature is limited to case reports and short case series. However there is a diverse assortment of benign and malignant soft tissue tumours that may involve the orbit. Techniques to identify tumour specific cytogenetic or molecular genetic abnormalities often resulting in over- expressed proteins are becoming an increasingly important ancillary technique for these tumours. This review focuses on 3 specific areas: 1. Orbital mesenchymal tumours where cytogenetics are important to reach the correct diagnosis. The majority of these are chromosomal translocations that often result in a fusion gene and protein product; 2. Orbital mesenchymal tumours where cytogenetics are important to identify patients who will do well versus those with a poorer prognosis. This is turn helps with therapeutic options. In some tumours e.g. synovial sarcoma the chromosomal translocations can occur with 2 different regions resulting in different fusion products that carry a different prognosis. Alternatively whilst the majority of alveolar rhadomyosarcomas are fusion positive a minority are fusion negative with a better prognosis; 3. Orbital mesenchymal tumours where the identification of specific cytogenetic abnormalities has resulted in overexpression of specfic proteins which are diagnostically useful biomarkers for immunohistochemistry.
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Affiliation(s)
- F. Roberts
- Department of Pathology, Queen Elizabeth University Hospital, Govan Road, Glasgow G51 4TF, United Kingdom
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37
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Sinonasal Tract Solitary Fibrous Tumor: A Clinicopathologic Study of Six Cases with a Comprehensive Review of the Literature. Head Neck Pathol 2017; 12:471-480. [PMID: 29282671 PMCID: PMC6232205 DOI: 10.1007/s12105-017-0878-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/12/2017] [Indexed: 12/17/2022]
Abstract
Solitary fibrous tumors (SFTs) are well recognized in the head and neck region, but rarely arise in the sinonasal tract (SNT). Six primary SNT SFTs were identified in the files of Southern California Permanente Medical Group between 2006 and 2017. The patients included five males and one female ranging in age from 33 to 72 years (mean 52 years), most of whom presented clinically with nasal obstruction. Three tumors involved the nasal cavity alone, one involved the paranasal sinuses, and two involved both the nasal cavity and paranasal sinuses. Histologically, the tumors were characterized by a variably cellular proliferation of cytologically bland spindle cells within a collagenous stroma with prominent interspersed branching vessels. Mitotic activity was low (range 0-2 per 10 high power fields) and there was no evidence of pleomorphism or tumor necrosis. Surface ulceration was noted. By immunohistochemistry, the lesional cells were positive for CD34, STAT6 and bcl-2. Clinical follow up information was available for all patients (range 32-102 months; mean 72 months). There were no recurrences or metastases and all were alive with no evidence of disease at last follow-up. SFTs rarely affect the SNT, but should be considered in the differential diagnosis of SNT mesenchymal lesions. Immunohistochemical expression of STAT6 can aid in diagnosis and separation of SFT from other spindle cell lesions occurring at this anatomic site. In combination with cases reported in the literature, primary SNT SFT behave in an indolent manner with conservative treatment.
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38
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Smith SC, Gooding WE, Elkins M, Patel RM, Harms PW, McDaniel AS, Palanisamy N, Uram-Tuculescu C, Balzer BB, Lucas DR, Seethala RR, McHugh JB. Solitary Fibrous Tumors of the Head and Neck: A Multi-Institutional Clinicopathologic Study. Am J Surg Pathol 2017; 41:1642-1656. [PMID: 28877055 PMCID: PMC5680135 DOI: 10.1097/pas.0000000000000940] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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 histiocytomas (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 52 years (range: 15 to above 89 y). 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 1 SFT and 1 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 GCA-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: 43 mo), 19 showed recurrence (40%). Of these, 4 patients were alive with disease and 4 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.
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Affiliation(s)
- Steven C Smith
- *Departments of Pathology and Surgery, VCU School of Medicine, Richmond, VA †Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA §Biostatistics Facility, University of Pittsburgh Cancer Institute **Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA ∥Department of Pathology, SUNY Upstate Medical University, Syracuse, NY Departments of ‡Pathology ¶Dermatology ††Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor #Department of Urology, Henry Ford Health System, Detroit, MI
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39
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Kouba E, Simper NB, Chen S, Williamson SR, Grignon DJ, Eble JN, MacLennan GT, Montironi R, Lopez-Beltran A, Osunkoya AO, Zhang S, Wang M, Wang L, Tran T, Emerson RE, Baldrige LA, Monn MF, Linos K, Cheng L. Solitary fibrous tumour of the genitourinary tract: a clinicopathological study of 11 cases and their association with the NAB2- STAT6 fusion gene. J Clin Pathol 2016; 70:508-514. [PMID: 27802414 DOI: 10.1136/jclinpath-2016-204088] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/03/2016] [Accepted: 10/08/2016] [Indexed: 01/11/2023]
Abstract
AIMS To characterise clinicopathological features and clinical outcomes of the genitourinary tract solitary fibrous tumours, incorporating NAB2-STAT6 gene fusion status. METHODS The presence of the molecular hallmark NAB2-STAT6 gene fusion and for the defining fusion partner product STAT6 was assessed in 11 cases of the genitourinary tract solitary fibrous tumours. NAB2-STAT6 gene fusion analysis was performed using a break-apart fluorescence in situ hybridisation (FISH) probe using a probe cocktail with Bacterial artificial chromosome (BAC) clones for STAT6 and NAB2. RESULTS Eleven solitary fibrous tumours were diagnosed in eight male patients and three female patients with a mean age of 46 years (range: 11-64 years). Four of the tumours had malignant histological features, and three were considered moderate risk for metastasis. With a mean follow-up time of 61 months, 1 recurred locally and 2 presented at distant metastatic sites. Using a break-apart FISH probe cocktail, we found the NAB2-STAT6 gene fusion and nuclear STAT6 expression in 58% and 91% of cases, respectively. However, the NAB2-STAT6 fusion status was not correlated with STAT6 expression or useful in discriminating between malignant histological features or subsequent clinical outcomes in the genitourinary solitary fibrous tumours. CONCLUSIONS A subset of solitary fibrous tumours of the genitourinary tract behaved aggressively. Using a break-apart FISH probe cocktail, we found the NAB2-STAT6 gene fusion in 64% of cases. However, the NAB2-STAT6 fusion status was not correlated with STAT6 expression or useful in discriminating between low-risk or high-risk tumours and subsequent clinical outcomes.
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Affiliation(s)
- Erik Kouba
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Novae B Simper
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shaoxiong Chen
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sean R Williamson
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, Michigan, USA
| | - David J Grignon
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - John N Eble
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gregory T MacLennan
- Departments of Pathology and Laboratory Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rodolfo Montironi
- Department of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), Ancona, Italy
| | - Antonio Lopez-Beltran
- Unit of Anatomical Pathology, Department of Surgery, Faculty of Medicine, Cordoba, Spain.,Champalimaud Clinical Center, Lisbon, Portugal
| | - Adeboye O Osunkoya
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Shaobo Zhang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mingsheng Wang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lisha Wang
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Thu Tran
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Robert E Emerson
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lee Ann Baldrige
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - M Francesca Monn
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Konstantinos Linos
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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40
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Yuzawa S, Tanikawa S, Kunibe I, Nishihara H, Nagashima K, Tanaka S. A case of giant cell-rich solitary fibrous tumor in the external auditory canal. Pathol Int 2016; 66:701-705. [PMID: 27714938 DOI: 10.1111/pin.12470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/02/2016] [Accepted: 09/14/2016] [Indexed: 01/30/2023]
Abstract
We present a rare case of giant cell-rich solitary fibrous tumor (SFT) arising at the left external auditory canal in a 31-year-old woman. The tumor was well-circumscribed and composed of spindle-shaped cells with abundant collagenous bands. Scattered multinucleate giant cells were observed, some of which lined pseudovascular spaces. Although a focal mild-hypercellular area was observed, mitoses were rare and necrosis was absent. Interstitial mast cells were scattered, especially in the hypercellular area. Immunohistochemically, CD34, vimentin, and Bcl-2 presented diffuse positivity. Moreover, both mononuclear spindle cells and multinucleate cells showed nuclear STAT6 positivity, while NAB2-STAT6 fusion gene could not be detected by reverse transcription polymerase chain reaction using formalin-fixed specimen. These findings suggest the pathological diagnosis of giant cell-rich SFT, previously known as giant cell angiofibroma, which is a rare variant of SFT with multinucleate giant cells and occurs predominantly in orbital region. Although giant cell-rich SFTs of extra-orbital sites have been reported, to our knowledge, this is the first case arising in the external auditory canal. Giant cell-rich SFT should be considered as a differential diagnosis of spindle cell lesion with multinucleate giant cells, and STAT6 immunohistochemistry should be performed to distinguish this rare tumor from other mesenchymal neoplasms.
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Affiliation(s)
- Sayaka Yuzawa
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Tanikawa
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Department of Diagnostic Pathology, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Isamu Kunibe
- Department of Otorhinolaryngology, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Hiroshi Nishihara
- Department of Translational Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Translational Research Laboratory, Hokkaido University Hospital, Clinical Research and Medical Innovation Center, Sapporo, Japan
| | - Kazuo Nagashima
- Department of Diagnostic Pathology, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Department of Translational Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Nakada S, Minato H, Nojima T. Clinicopathological differences between variants of the NAB2–STAT6 fusion gene in solitary fibrous tumors of the meninges and extra-central nervous system. Brain Tumor Pathol 2016; 33:169-74. [DOI: 10.1007/s10014-016-0264-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 05/30/2016] [Indexed: 01/06/2023]
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42
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Chuang IC, Liao KC, Huang HY, Kao YC, Li CF, Huang SC, Tsai JW, Chen KC, Lan J, Lin PC. NAB2-STAT6gene fusion and STAT6 immunoexpression in extrathoracic solitary fibrous tumors: the association between fusion variants and locations. Pathol Int 2016; 66:288-96. [DOI: 10.1111/pin.12408] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/10/2016] [Accepted: 03/15/2016] [Indexed: 12/26/2022]
Affiliation(s)
- I-Chieh Chuang
- Department of Anatomical Pathology
- Bone and soft tissue study group; Taiwan Society of Pathology
| | | | - Hsuan-Ying Huang
- Department of Anatomical Pathology
- Bone and soft tissue study group; Taiwan Society of Pathology
| | - Yu-Chien Kao
- Department of Pathology; Shuang Ho Hospital, Taipei Medical University; Taipei
- Bone and soft tissue study group; Taiwan Society of Pathology
| | - Chien-Feng Li
- Department of Pathology; Chi-Mei Medical Center; Tainan
- Bone and soft tissue study group; Taiwan Society of Pathology
| | - Shih-Chiang Huang
- Department of Anatomical Pathology; Chang Gung Memorial Hospital, Chang Gung University College of Medicine; Taoyuan
- Bone and soft tissue study group; Taiwan Society of Pathology
| | - Jen-Wei Tsai
- Department of Anatomic Pathology; E-Da Hospital; Kaohsiung Taiwan
- Bone and soft tissue study group; Taiwan Society of Pathology
| | - Ko-Chin Chen
- Department of Pathology; Changhua Christian Hospital; Changhua Taiwan
- Bone and soft tissue study group; Taiwan Society of Pathology
| | - Jui Lan
- Department of Anatomical Pathology
- Bone and soft tissue study group; Taiwan Society of Pathology
| | - Po-Chun Lin
- Department of Orthopedics; Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Kaohsiung
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