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Case Reports
. 2023 Mar 30;15(3):e36901.
doi: 10.7759/cureus.36901. eCollection 2023 Mar.

Solitary Fibrous Tumour: A Rare Differential Diagnosis of Unilateral Nasal Mass

Zi Hao Chew  1   2 , Eng Haw Lim  2 , Mohd Eksan Sairin  2 , Aneeza Khairiyah Wan Hamizan  1
Affiliations
Case Reports

Solitary Fibrous Tumour: A Rare Differential Diagnosis of Unilateral Nasal Mass

Zi Hao Chew et al. Cureus. .

Abstract

Solitary fibrous tumors of the nasal cavity and paranasal sinuses are rarely encountered in clinical practice. These are unusual mesenchymal tumours initially described as primary spindle-cell neoplasms. Such tumours may manifest in pleural and extrapleural sites such as the liver, parapharyngeal space, sublingual and parotid glands, and thyroid but are seldom described in the nose and paranasal sinus region. Erosion of adjacent structures may occur, but the tumour itself does not metastasise. A young patient presented with a progressive unilateral nasal mass. The initial nasal biopsy reported it as a benign inflammatory nasal polyp. Imaging revealed a large, locally expansile mass within the right nasal cavity displacing the nasal septum. The patient underwent excision of the tumour and the diagnosis of solitary fibrous tumour was confirmed by immunohistochemistry staining. This case is intended to highlight the diagnosis and management of this rare tumour.

Keywords: benign inflammatory nasal polyp; nasal cavity; nasal obstruction; paranasal sinus; solitary fibrous tumour.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Nasoendoscopy showed a huge solid tumor (arrow) occupying almost the entire right nasal cavity.
S: septum
Figure 2
Figure 2. CT depicted a tumor in the right nasal cavity (arrow) causing contralateral bowing of the nasal septum with the erosion of the nasal septum and right lateral nasal wall. (A) Axial cut showed anteroposterior extension of the tumor whereas (B) coronal cut showed superior extension towards the roof of the nasal cavity.
Figure 3
Figure 3. (A) The tumor cells are composed of spindle-shaped cells with varying orientations. Note the ectatic vessels of varying sizes (arrow). (B) The tumor cells are diffusely positive for STAT6 which confirms the diagnosis.
STAT6: signal transducer and activator of transcription 6
Figure 4
Figure 4. Postoperative nasoendoscopy revealed a spacious right nasal cavity with no signs of recurrence of the tumor.
S: septum; MT: middle turbinate
See this image and copyright information in PMC

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