[Clinical analysis of 12 cases of solitary fibrous tumors in nasal cavity, sinuses and skull base]

Abstract

Objective:To summarize and analyze the clinical manifestations, diagnosis and management and prognostic features of solitary fibrous tumor（SFT） in nasal cavity, sinus and skull base. Methods:The clinical data of 12 patients with STF from nasal cavity, sinus and cranial base admitted to the Affiliated Hospital of Qingdao University from April 2014 to January 2022 were retrospectively analyzed, including 4 patients admitted to the department of Otolaryngology head and neck surgery and 8 patients admitted to the department of skull base surgery The clinical characteristics, diagnosis, management and prognosis were analyzed. Results:Twelve patients were included in this research, including 7 males and 5 females. All patients received surgical treatment, and 4 patients also received postoperative adjuvant chemoradiotherapy. After follow-up for 12-60 months, 4 patients with adjuvant radiotherapy and chemotherapy had a good prognosis, and among 8 patients who did not receive radiotherapy and chemotherapy, 6 patients had good prognosis and 2 patients showed relapse. Four patients with a history of recurrence of SFT after surgery were admitted to our hospital for surgical treatment, in which 1 patient had relapse after surgery, and none had metastasis. Nasal cavity and sinus to skull base SFT is rare. The most effective treatment for this disease is surgical resection, and postoperative adjuvant chemoradiation and long-term follow-up can achieve a better prognosis. En bloc resection is the key to treatment success.

Keywords: basicranial tumor; nasal and sinus tumors; solitary fibrous tumor.

图 1

术前电子纤维喉镜   右侧鼻腔呈术后改变，可见脓涕倒流，咽鼓管口通畅，咽隐窝、鼻咽顶后壁无新生物；图2  术前颅脑CT检查   2a：失状位；2b：轴位；右侧额叶可见团块状高低混杂密度影，边界欠清；图3  术前颅脑MRI平扫所见   3a：失状位；3b：轴位(鼻腔鼻窦平面)；3c：轴位(额叶平面)；右侧额叶可见团块状不均匀信号影，长径约30 mm，内部似见分隔，边界清晰；图4  术后22个月颅脑MRI平扫所见   4a：失状位；4b：轴位(鼻腔鼻窦平面)；4c：轴位(额叶平面)；恢复良好无复发，符合鼻窦术后改变。图5  术后病理检查   镜下见大量梭形及卵圆形细胞，结合免疫学表型特征，符合SFT(中间性肿瘤)；5a：苏木精-伊红染色×10；5b、5c：苏木精-伊红染色×40；5d：STAT6染色×10；5e：CD99染色×10；5f：CD34染色×10。