Solitary fibrous tumor of the nasal cavity and orbit

Our plain-English summary of Solitary fibrous tumor of the nasal cavity and orbit, by M. Fukunaga, S. Ushigome, K. Nomura, et al (Pathology International, 1995).

The study

• Authors: M. Fukunaga, S. Ushigome, K. Nomura, E. Ishikawa
• Journal: Pathology International
• Published: 1995;45(12):952-7
• Type of article: Case report
• Cited by: 56 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Solitary fibrous tumors (SFT) are rare spindle cell neoplasms generally associated with the serosal surface, especially the pleura. Two SFT are reported arising in the nasal cavity and orbit, occurring in a 33 year old female and a 21 year old male, respectively. The lesions lacked the characteristic features of other recognized neoplasms that occur in these regions. Immunohistochemically, the tumors cells were diffusely and strongly positive for vimentin and CD34 and some or many tumor cells expressed neuron-specific enolase and Leu-7. Ultrastructurally, the tumor cells showed no distinct features although they were suggested to be primitive mesenchymal or fibroblast-like cells. Both tumors were diploid by flow cytometry. The two patients have had benign clinical courses with limited follow-up. Our findings suggest that SFT is of mesenchymal cell origin and support another location for SFT, indicating additional evidence against mesothelial origin. SFT should be included in the differential diagnosis of spindle cell tumors arising in the nasal cavity and orbit.

In plain English

This case report, from the Department of Pathology at The Jikei University School of Medicine in Tokyo, described two solitary fibrous tumors. The authors noted that this rare tumor typically arises in the pleura and was once called 'localized mesothelioma'. One tumor filled the right nasal cavity of a 33 year old Japanese woman and was removed by polypectomy. The other was in the left orbit (eye socket) of a 21 year old Japanese man and was cut out. Under the microscope, both were made of spindle-shaped cells with minimal atypia and 0 to 1 dividing cells per 50 high-power fields. The tumor cells stained strongly for vimentin and CD34 but not for epithelial markers, muscle markers or S-100 protein. Both tumors were diploid on flow cytometry, with S-phase fractions of 10.3% and 6.0%. The woman had no evidence of disease 3 months later, and the man 22 months later. The authors described this follow-up as limited. The authors concluded that their findings suggest these tumors arise from mesenchymal cells and add evidence against a mesothelial origin. The article does not discuss asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report of two patients (pathology, immunohistochemistry, electron microscopy and flow cytometry)
• Who was studied: Two Japanese patients studied at The Jikei University School of Medicine, Tokyo: a 33 year old woman with a nasal cavity tumor and a 21 year old man with an orbital tumor; dates not given
• Main results:
  • Case 1 (woman): a polypoid nasal tumor measuring 3.5 x 2.0 x 1.5 cm was removed by polypectomy; she was alive with no evidence of disease 3 months later
  • Case 2 (man): a left medial orbital tumor measuring 4.5 x 2.0 x 2.0 cm was excised; he was alive with no evidence of disease 22 months later
  • In both tumors, mitotic activity ranged from 0 to 1 per 50 high-power fields
  • Tumor cells in both cases were diffusely and strongly positive for vimentin and CD34. The body text also lists Leu-7 here, while the abstract says only some or many cells expressed Leu-7
  • Tumor cells were uniformly negative for epithelial markers, muscle markers (including desmin and alpha-smooth muscle actin), S-100 protein and other markers tested
  • Both tumors had a diploid DNA content on flow cytometry, with S-phase fractions of 10.3% (Case 1) and 6.0% (Case 2)
  • Case 1 showed so-called 'amianthoid' fibers, which the authors described as structures made of thick collagen fibers
• The authors' conclusion: The authors concluded that their findings suggest solitary fibrous tumor is of mesenchymal cell origin, support another location for it, and give additional evidence against mesothelial origin. They also concluded that solitary fibrous tumor should be considered in the differential diagnosis of spindle cell tumors of the nasal cavity and orbit, and that it may be a benign or low grade malignancy
• Limitations the authors state:
  • Follow-up of the two patients was limited

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Solitary Fibrous Tumor, Spindle Cell, Neoplasm, Serosal Surface, Pleura, CD34, Fibroblast, Differential Diagnosis.

Related studies

• Solitary fibrous tumour of the orbit — R. Sciot, J. Goffin, et al. (1996)
• Solitary fibrous tumour of the nasal cavity and paranasal sinuses — I. Alobid, L. Alós, et al. (2003)
• Solitary fibrous tumor of the orbit: CT and pathologic correlation — S. Festa, H.J. Lee, et al. (1999)
• Atypical solitary fibrous tumor of the nose and maxillary sinus — I. Papadakis, E. Koudounarakis, et al. (2013)
• Solitary fibrous tumors of the pleura: clinical characteristics, surgical treatment and outcome — P. Magdeleinat, M. Alifano, et al. (2002)
• A case of malignant pleural mesothelioma with metastasis to the orbit — K. Kubota, K. Furuse, et al. (1996)

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