Endonasal endoscopic resection of an ethmoidal solitary fibrous tumor

Abstract

Solitary fibrous tumor (SFT) is an uncommon spindle cell tumor that typically arises at the level of the pleura in adults. However, SFT has also been reported in various extrapleural sites including orbit, meninges, liver, lung, salivary glands, retroperitoneum, mediastinum. In the head and neck region, SFT has been documented in the external auditory canal, larynx, thyroid, sublingual gland, tongue, parapharyngeal space and the infratemporal fossa. The nose and the paranasal sinuses are a rare site for SFT with only 14 publications in the world literature. We present an additional case of a SFT arising at the level of the right ethmoid sinus successfully removed in one piece endoscopically and review the corresponding literature.

Endoscopic treatment of juvenile nasopharyngeal angiofibromas: our experience and review of the literature

“…The endoscopic resection of tumors in the nasal cavity, paranasal sinuses and pterygopalatine fossa is well established compared with the external approaches [9,12,[19][20][21][22]. Intraoperative visualization of the tumor limits in the complex area of the pterygopalatine fossa, with endoscopes of various angles, is superior to that of the unaided eye.…”

“…Budzynowska et al [29] have used intratumoral injections of tissue adhesive glue to minimize vascularity. Preoperative embolization of external carotid branches 24-48 h preoperatively provides a bloodless field, reduces the blood loss and the need for transfusion [1,9,12,21,[30][31][32]. If the tumor extends intracranially or into the skull base, the likelihood of internal carotid artery contribution to its vascularity is high.…”

“…Management options for residual or recurrent tumors are (a) a wait-and-see policy with follow-up endoscopy and imaging, (b) reoperation (endoscopic or open approach) and (c) radiotherapy. Several authors reported that asymptomatic residual nodules remain unchanged or regress without any additional treatment [5,9,10]. It has been postulated that JNAs undergo a natural cycle of aggressive growth followed by regression in some cases [37]; therefore it is not known if undetected residual disease during surgery will gain clinical significance postoperatively.…”

“…The endoscopic resection of JNA was introduced in the early 90 s [8] and nowadays, several authors advocate its use [2,[9][10][11][12].…”

Solitary Fibrous Tumor of the Sinonasal Cavity: CT and MR Imaging Findings

“…SFTs of the sinonasal cavity are rare, with fewer than 30 cases reported in the English literature to date. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Although several case reports and clinical studies have mentioned imaging findings of SFTs in this region, 6,12,15 the specific imaging characteristics of sinonasal SFT have not been detailed in the literature. We present the CT and MR imaging features of 5 patients with sinonasal SFTs proved by histopathology.…”