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Case Reports
. 2024 Nov 26;18(1):124.
doi: 10.1007/s12105-024-01731-5.

Solitary Fibrous Tumor of the Mandible

Thamyres Campos Fonsêca  1 , Michelle Agostini  1 , Jefferson Viapiana Paes  2 , Ana Luiza Oliveira Corrêa Roza  3 , Willie F P van Heerden  4 , Mário José Romañach  5 , Aline Corrêa Abrahão  1
Affiliations
Case Reports

Solitary Fibrous Tumor of the Mandible

Thamyres Campos Fonsêca et al. Head Neck Pathol. .

Abstract

A 41-year-old woman presented with a facial asymmetry in the mental region and a painful, well-circumscribed, tender mass in the right lower buccal vestibule, associated with extensive ill-defined bone rarefaction with subtle cortical bone resorption. Microscopically, a proliferation of bland spindle cells interspersed with collagen fibers and prominent staghorn-like blood vessels was observed. Immunohistochemical analysis revealed strong positivity for CD34, Bcl-2, CD99, and STAT-6, confirming the diagnosis of Solitary Fibrous Tumor (SFT). Conservative surgical enucleation was performed, and 4 years later, recurrence was observed with extensive bone involvement and moth-eaten margins resembling a malignant tumor. SFT is a distinctive spindle cell tumor of fibroblastic differentiation, characterized by prominent branching staghorn-like vessels and a specific NAB2::STAT6 gene fusion. We herein contribute with a central SFT of the mandible with recurrent behavior and radiographic appearance suggesting malignancy.

Keywords: Mandible; Oral; Recurrent; Solitary Fibrous Tumors.

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Conflict of interest statement

Declarations. Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Conflict of Interest: The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
A-C: Initial clinical presentation of exuberant facial asymmetry caused by a well-circumscribed swelling of smooth surface, located in the right lower buccal vestibule. Cutaneous superficial telangiectatic blood vessels covered the lesion (A-B, extraoral examination; C, intraoral examination). D-F. The tumor exhibited an ill-defined bone rarefaction, leading to slight buccal bone cortical resorption (yellow arrows). G. Grossly, the tumor appeared as an incompletely removed soft tissue fragment of fibrous consistency and ill-defined irregular base; a central staghorn blood vessel is evident (blue arrows). (D-F, Cone-beam computerized tomography; G, macroscopic examination) H-J. Four years later, a large hypodense lesion of irregular margins was noted causing exuberant bone destruction and cortical disruption. K. the gross appearance of the persistent tumor was of an ill-defined and lobular fibrous tumor. (H-J, Cone-beam computerized tomography; K, macroscopic examination) L-M. Microscopic evaluation showing haphazardly arranged spindle to ovoid cells with indistinct eosinophilic cytoplasm and bland ovoid nuclei within a collagenous stroma were admixed with hyalinized staghorn blood vessels, and diffusely positive for STAT-6 in nuclear pattern (L, H&E, 100x, [Insert 400x]; M, Immunoperoxidase, 100x)
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