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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