Orbital Solitary Fibrous Tumor: Four Case Reports—Clinical and Histopathological Features

Carmen Navarro-Perea,Enrique Mencía-Gutiérrez,María-C Garrido,Silvia Pérez-Trigo,Cristina Calleja-García,Álvaro Bengoa-González,Stephen G Schwartz

doi:10.1155/2021/5822859

Carmen Navarro-Perea, Enrique Mencía-Gutiérrez + Show 5 more

Open Access

https://doi.org/10.1155/2021/5822859

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Abstract

Purpose To retrospectively describe the clinical characteristics, management, and outcomes of four cases of orbital solitary fibrous tumor (SFT). In one patient, we present an ultrasonic aspirator system for tumor removal. Methods Four patients with orbital SFT were selected: one patient with orbital SFT, another patient with frontal and ethmoidal SFT and orbital affectation with high rates of recurrence, the third patient with frontal lobe SFT and orbital invasion with multiple recurrences, and the fourth case with a history of craniopharyngioma surgery and SFT located on the orbital apex. Results All cases showed proptosis, eye movement restriction, and, in three cases, visual acuity alteration. Different treatments were applied: in three cases, excision was performed, one of them with an ultrasonic aspirator system, and in the remaining case, an exenteration was done (in two cases, radiosurgery treatment was also applied). The immunohistochemical study revealed SFT, similar to hemangiopericytomas (HPCs). No recurrence has been observed after surgical treatment. Conclusion The SFT is a spectrum of different tumors with similar histopathological characteristics. The use of immunohistochemical markers is very helpful in the diagnosis. The main problem of orbital involvement is the risk of damaging important structures adjacent to the tumor during the surgical removal. The ultrasonic aspirator system allows elimination of the tumor without damaging other orbital structures.

Highlights

Solitary fibrous tumor (SFT) is a rare tumor which was first described in the visceral pleura in 1931 by Klemperer and Rabin [1]
The second case is a 74-year-old woman who had been receiving follow-up monitoring in otorhinolaryngology for 8 years for a frontal and ethmoidal SFT located on the right side; the SFT had been operated on five times for multiple recurrences despite complete resections
We found that 150 cases of orbital SFT have been described in the English literature [4]

Summary

Introduction

Solitary fibrous tumor (SFT) is a rare tumor which was first described in the visceral pleura in 1931 by Klemperer and Rabin [1]. SFT was first described in the orbit in 1994 by Westra et al [3], and since there have been published 150 cases in English literature [4]. They are usually benign, there are specific malignant cases with frequent local recurrences and invasion of adjacent structures [5, 6]. We describe the use of SONOPET® (Stryker, Kalamazoo, MI, USA) ultrasonic aspirator system for the tumor excision postincisional biopsy. It is a surgical tool that uses low-frequency ultrasonic vibrations to fragment tissue while simultaneously irrigating and aspirating the surgical field [8]

Case 1

Case 2

Case 3

Case 4

Discussion

Conclusion