Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9670
Peer-review started: May 27, 2022
First decision: June 27, 2022
Revised: July 5, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 26, 2022
Solitary fibrous tumor (SFT) is predominant within the pleura but very rare in the orbit, which is why the diagnosis of orbital SFT poses challenges in clinical practice. Accordingly, an integrated approach that incorporates specific clinical features, histological, histopathological, and immunohistochemical (IHC) examinations, and molecular analyses is warranted.
To retrospectively explore the clinical and imaging characteristics, treatment, outcomes of a series of patients with orbital SFT.
We conducted a retrospective review of a series of patients diagnosed with a histopathologic orbital SFT treated at a single institution. All data on demogra
In total, 13 patients were enrolled, 7 (53.8%) of whom had the tumor located in the superomedial quadrant of the orbit. Computed tomography revealed a solitary ovoid lesion in 10 (76.9%) patients and irregular lesion in 3 (23.1%) patients. Magnetic resonance imaging results were as follows: On T1 weighted images, 3 (23.1%) patients had hypointense mixed signals, whereas 10 (76.9%) patients showed isointense mixed signals; on T2 weighted images (T2WI), 3 (23.1%), 4 (30.8%), and 6 (46.2%) patients exhibited hypointense mixed, isointense mixed, and hyperintense signals, respectively. Notably, 12 (92.3%) patients showed significant enhancement, whereas there were patchy slightly enhanced areas in the tumor. All patients were treated by surgery. IHC analysis demonstrated that the tumor cells were immunoreactive for CD34, CD99, STAT-6, and vimentin in all patients. The lesions showed Ki-67 positivity < 5% in 1 (7.7) patient, 5%-10% in 10 (76.9%), and > 10% in 2 (15.4%). Two (15.4%) patients exhibited tumor recurrence.
The clinical manifestations and radiologic characteristics of orbital SFT are diverse and not specific. Accurate diagnosis and treatment require detailed radiological and histopathological/ IHC evaluation.
Core Tip: The clinical manifestations of orbital solitary fibrous tumor (SFT) are diverse and not specific. In most cases, the lesions occur outside the muscular cone, are localized at the superomedial quadrant and inferomedial quadrant of the orbit. The mean computed tomography values of lesions are variable, and the signal of lesions on magnetic resonance imaging is uncertain. Contrast-enhanced imaging showed that most part of the lesions was significantly enhanced, whereas there were patchy slightly enhanced areas in them. Delineating SFT from histologic mimics requires nuclear staining for STAT6 as a diagnostic adjunct in conjunction with CD34 positivity. Ki-67 labelling index may be extremely low, and malignant forms with an enhanced propensity for local recurrence have been reported.