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SOLITARY FIBROUS TUMOR IN THE ORAL CAVITY: A CASE REPORT
DEP. OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY, RIZAL MEDICAL CENTER
JENNIFER ANNE C., JENNIFER ANNE C. TEVES
This is a case of a 23-year-old male with a 4-year history of gradually enlarging painless mass on the right lateral side of the tongue. No associated paresthesia, nor limitation in tongue movement. Physical examination revealed a 2 x 2 cm exophytic, firm, fixed, nontender mass on the right lateral tongue. A wedge biopsy of the right lateral tongue mass revealed spindle cell neoplasm. Immunohistochemical staining for TLE1, P40, CD31, desmin, S100 AND Ki67 revealed a low-grade spindle neoplasm most compatible with a solitary fibrous tumor. The patient underwent wide excision of right lateral tongue mass with adequate margins, negative for tumor. Postoperatively, the patient underwent speech therapy. The final histopathology revealed solitary fibrous tumor, which is a rare tumor comprising 2 % of all soft tissue tumors. Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms of mesenchymal origin. They were first documented in 1931 (Klemperer and Rabin 1931), with the neoplasms found arising from pleural cavity. To date, there is no published data in the Philippines, on solitary fibrous tumor in the oral cavity. This case aims to document the clinical course of a patient with solitary fibrous tumor in the oral cavity as well as treatment modality and tumor surveillance. These tumors were described as gradually enlarging soft tissue masses that were often found difficult to distinguish from the spectrum of soft tissue tumors such as fibroma, dermatofibrosarcoma and schwannoma. With the patient¡¯s clinical profile, deriving at diagnosis of Solitary fibrous tumor is difficult to identify preoperatively. Presence of NAB2- STAT6 fusion detected with a STAT6 antibody is a highly sensitive and specific marker for solitary fibrous tumors. Several markers may also be included in the panel such as CD 34, BCL 2, vimentin and CD 99 but are of low sensitivity and specificity. The current treatment modality is surgical excision. Clinical evaluation for tumor surveillance is recommended, with follow up done up to 45.8 months.


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