Professional Documents
Culture Documents
doi:10.1093/jjco/hyu100
Advance Access Publication 5 August 2014
First author: Ying Xue, (1971.08.29), doctor, doctor-in-charge, mainly engaged in the comprehensive treatment of
chest tumor.
Objective: Solitary fibrous tumor is a rare tumor occurring in almost every anatomic location of
human body; however, reports of malignant solitary fibrous tumor in the nasal and paranasal
area are especially rare. In this report, we describe a case of non-recurrent malignant solitary
fibrous tumor of the nasal and paranasal area.
Methods: The patient was initially treated with nasal and paranasal tumor cytoreductive
surgery, followed by post-operative three-dimensional conformal intensity modulated radiation
therapy (dynamic MLC Varian 600CD Linac, inversely optimized by the Eclipse system) and
stereotactic body radiation therapy to provide a radical cure for residual tumor.
Results: The tumor of the nasal and paranasal area was effectively treated and the integrity of the
right eye kept. There were no signs of recurrence after four and a half years of further follow-up.
Conclusions: This is the first attempt to successfully combine cytoreductive surgery with intensity modulated radiation therapy and stereotactic body radiation therapy together to treat solitary
fibrous tumor of the nasal and paranasal area, which may provide a potential strategy for the
treatment of similar cases.
Key words: solitary brous tumor radiotherapy
INTRODUCTION
Solitary brous tumor (SFT) is an uncommon spindle cell tumor
that was rst recognized and fully characterized in 1994 by
Westra et al. (1). SFT often originates from the pleura, and occasionally from other parts of the body, including the extremities,
mediastinum, peritoneum, parotid gland and orbit (16). Radical
surgical resection is the preferred treatment for SFT. Here, we
present a case of malignant SFT of the nasal and paranasal area
that was treated by cytoreductive surgery combined with intensity
modulated radiation therapy (IMRT) and solitary brous tumor
(SBRT). No recurrence was seen in long-term follow-up.
CASE REPORT
An 18-year-old female was admitted to the Xijing Hospital of
Shaanxi Province, China in April due to painless proptosis,
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Figure 2. Hematoxylin and eosin-stained slide. (A) Microscopic examination of the orbit lesion shows proliferation of relatively uniform spindle cells that are
either patternless or have a focally storiform pattern. (B) Focal vascular dilatation with collagenized stroma, dense collagen nodules and perivascular hyalinization
is also observed.
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Figure 3. Immunohistochemical test of the SFT. Immunohistochemical tests showed that the tumor was positive for CD99 (A), Vim (B) and Bcl-2 (C), and
contains scattered CD34-positive cells (D). Ki67-positive cells accounted for 28% of all cells (E). All cells are negative for S-100 (F).
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DISCUSSION
CONCLUSION
In this report, we described a case of malignant SFT originating from the nasal and paranasal area. Following cytoreductive surgery, two post-operative radiation therapies of IMRT
and SBRT were performed; no recurrences or metastases occurred during long-term follow-up. Therefore, this report indicates an effective strategy for the treatment of malignant SFT
of the nasal and paranasal area. More research and longer
follow-up should be explored in the future based on the
recommended strategy.
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