Solitary fibrous tumor of the orbit?two cases and a review of the literature

Abstract

Solitary fibrous tumors of the orbit (SFT) are mesenchymal lesions that can develop either as malignant or benign neoplasias. We describe the histological features leading to the diagnosis in two females and review the current literature. Diagnosis of SFT only can be performed by histological examination, since clinical signs and radiological features are not specific enough. Even a malignant or benign course cannot be predicted, since clinical and radiological features do not correlate with histological signs of malignancy and vice versa. Radical resection is the treatment of choice, since no other treatment option has been proven to be efficient. Abstract Solitary fibrous tumors of the orbit (SFT) are mesenchymal lesions that can develop either as malignant or benign neoplasias. We describe the histological features leading to the diagnosis in two females and review the current literature. Diagnosis of SFT only can be performed by histological examination, since clinical signs and radiological features are not specific enough. Even a malignant or benign course cannot be predicted, since clinical and radiological features do not correlate with histological signs of malignancy and vice versa. Radical resection is the treatment of choice, since no other treatment option has been proven to be efficient.

Solitary Fibrous Tumor of the Orbit: CT and MR Imaging Findings

“…16,19 In our 6 cases of orbital SFT, 3 lesions were found in the various locations of the intraconal or extraconal space of the orbit, 2 in the lacrimal sac, and 1 on the lower eyelid. In both of the 2 lacrimal sac lesions that had previously been reported, 10 the proximal nasolacrimal duct was also involved by the inferior growth of the tumor.…”

“…15,16 The review of the literature reveals a recent trend of rather rapid accumulation of the number of orbital SFTs, and so far more than 50 cases of orbital SFT have been reported in the English-language literature. [10][11][12][13][14][15][16][17][18][19][20][21] Bernardini et al 15 questioned the rarity of orbital SFT. According to these authors, thanks to the widespread use of immunohistochemical studies, the number of orbital SFTs has rapidly been increasing after 1994 when the first orbital SFT was reported.…”

“…5 Compared with the cerebral cortex or muscle, the signal intensity of SFT seen on MR images, in general, has been reported to be isointense on T1-weighted images and isointense to hypointense on T2-weighted images, reflecting fibrous tissue with high collagen content. 5,12,13,16,17,19,23,26 Sometimes, areas of hyperintense signal intensity are seen within the lesion on T2-weighted images, causing signal intensity heterogeneity on T2-weighted images. These areas of T2 hyperintensity are related to internal hemorrhage, cystic degeneration, or relatively fresh fibrosis.…”

“…5,7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Usually, the tumor is seen as a well-defined soft tissue mass with heterogeneously or homogeneously strong enhancement on CT and MR images. Occasional internal calcifications and necrosis have also been reported.…”

“…[2][3][4][5][6][7] Since the first report of 2 cases of orbital SFT in 1994, 8 the orbit has become one of the common sites of the head and neck involved by the tumor, and more than 50 cases of orbital SFT have been reported mostly in the ophthalmologic and pathologic literature. [9][10][11][12][13][14][15][16][17][18][19][20][21] To our knowledge, however, systematic analysis of the imaging features of orbital SFT has seldom been reported in the radiologic literature. The purpose of this study was to describe the characteristic CT and MR imaging findings of 6 cases of patients with SFT of the orbit proved on pathologic examination.…”