Solitary Fibrous Tumors of the Head and Neck: A Single-Institution Study of 52 Patients

Hye Rhyn Chung; Kenric Tam; Albert Y Han; Farres Obeidin; Manando Nakasaki; Dinesh K Chhetri; Maie A St John; Ashley E Kita

doi:10.1177/2473974X221098709

Solitary Fibrous Tumors of the Head and Neck: A Single-Institution Study of 52 Patients

OTO Open. 2022 Jul 12;6(3):2473974X221098709. doi: 10.1177/2473974X221098709. eCollection 2022 Jul-Sep.

Authors

Hye Rhyn Chung¹, Kenric Tam², Albert Y Han², Farres Obeidin³, Manando Nakasaki³, Dinesh K Chhetri^{2

4}, Maie A St John^{2

4

5}, Ashley E Kita²

Affiliations

¹ David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
² Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
³ Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
⁴ UCLA Head and Neck Cancer Program, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
⁵ Department of Biomedical Engineering, University of California-Los Angeles, Los Angeles, California, USA.

Abstract

Objective: To evaluate the clinicopathologic characteristics of head and neck solitary fibrous tumors and features that may predict tumor recurrence.

Study design: Retrospective review.

Setting: University of California-Los Angeles Medical Center.

Methods: A single-center retrospective study was conducted on pathologically confirmed cases of head and neck solitary fibrous tumors between 1996 and 2021. Patient demographics, clinical course, and histopathologic features were evaluated. Recurrence-free survival was estimated via Kaplan-Meier analysis.

Results: A total of 52 patients were reviewed. The average patient age was 54.7 years (range, 15-89). The most common subsite was the orbit (53.8%, n = 28), but other involved areas included the nasopharynx, paranasal sinuses, and scalp. The median tumor size was 2.95 cm (range, 1.3-11.2). Strong STAT6 (100%) and CD34 (97.9%) expression was observed on immunohistochemistry. Almost all patients were initially managed with wide local excision; 82% of patients (n = 14) had positive margins on pathologic review; and 15% (n = 4) had recurrence at a median 28.5 months (range, 10-113). White patient race was the only significant predictor of tumor recurrence. Patient age (≥55 years), tumor size (≥4), high mitotic rate, and disease subsite were not associated with recurrence.

Conclusion: Head and neck solitary fibrous tumors demonstrate a significantly larger local recurrence rate as compared with their rate of metastasis. They can recur many years following initial therapy, warranting long-term surveillance and follow-up to assess for tumor recurrence.

Keywords: clinicopathologic features; hemangiopericytoma; immunohistochemistry; solitary fibrous tumor.