TY - JOUR
T1 - 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
AU - Tariq, Muhammad Usman
AU - Asghari, Tamana
AU - Armstrong, Susan M.
AU - Ahmed, Arsalan
AU - Fritchie, Karen
AU - Din, Nasir Ud
N1 - Publisher Copyright:
© 2023
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
KW - Head and neck
KW - Recurrence
KW - Risk stratification
KW - STAT6
KW - Solitary fibrous tumor
UR - http://www.scopus.com/inward/record.url?scp=85169016887&partnerID=8YFLogxK
U2 - 10.1016/j.prp.2023.154777
DO - 10.1016/j.prp.2023.154777
M3 - Article
C2 - 37639955
AN - SCOPUS:85169016887
SN - 0344-0338
VL - 249
JO - Pathology Research and Practice
JF - Pathology Research and Practice
M1 - 154777
ER -