Total resection combined with osteotomy is more effective for orbital solitary fibrous tumor excision: a report of three cases

  • Katsuya Tanaka
  • Hiroki Yano
  • Hiroko Hayashi
  • Akiyoshi Hirano
Case Report


A solitary fibrous tumor is a neoplasm generally arising from the mesothelial surfaces of the pleura and mesothelium. In this paper, we describe three cases of rare solitary fibrous tumors arising from the orbit and discuss the management of the tumors, including diagnosis and treatment. All three cases were treated by surgical resection and showed satisfactory aesthetic and functional results. For a definitive diagnosis, immunohistochemical staining for proteins such as vimentin, CD34 and bcl-2 and hematoxylin and eosin (H&E) staining for identifying the morphological characteristics of spindle cell tumors with a partially storiform pattern and staghorn vessels are indispensable. The principle of treatment for orbital solitary fibrous tumor is complete resection because the prognosis depends on controlling tumor progression, which can be difficult with chemotherapy and radiotherapy alone.


Orbital tumor Solitary fibrous tumor Pathology Immunohistochemistry Surgical treatment 



This work was supported by JSPS KAKENHI (Grant numbers 26670773 and 26861503).

Conflict of interest

The authors report no conflicts of interests.


  1. 1.
    Gold JS, Antonescu CR, Hajdu C, Ferrone CR, Hussain M, Lewis JJ, Brennan MF, Coit DG (2002) Clinicopathologic correlates of solitary fibrous tumors. Cancer 94(4):1057–1068CrossRefPubMedGoogle Scholar
  2. 2.
    Heim-Hall J, Yohe SL (2008) Application of immunohistochemistry to soft tissue neoplasms. Arch Pathol Lab Med 132(3):476–489. doi: 10.1043/1543-2165(2008)132[476:AOITST]2.0.CO;2 PubMedGoogle Scholar
  3. 3.
    Bejarano Gonzalez N, Garcia Borobia FJ, Romaguera Monzonis A, Garcia Monforte N, Falco Fages J, Bella Cueto MR, Navarro Soto S (2015) Solitary fibrous tumor of the liver. Case report and review of the literature. Revista espanola de enfermedades digestivas organo oficial de la Sociedad Espanola de Patologia Digestiva. doi: 10.17235/reed.2015.3676/2014 Google Scholar
  4. 4.
    Morimitsu Y, Nakajima M, Hisaoka M, Hashimoto H (2000) Extrapleural solitary fibrous tumor: clinicopathologic study of 17 cases and molecular analysis of the p53 pathway. Acta pathologica microbiologica et immunologica Scandinavica 108(9):617–625CrossRefGoogle Scholar
  5. 5.
    Toniato A, Boschin IM, Pelizzo MR (2014) A very rare bilateral adrenal tumor. Endocrine 45(3):502–503. doi: 10.1007/s12020-013-0082-0 CrossRefPubMedGoogle Scholar
  6. 6.
    Westra WH, Gerald WL, Rosai J (1994) Solitary fibrous tumor. Consistent CD34 immunoreactivity and occurrence in the orbit. Am J Surg Pathol 18(10):992–998CrossRefPubMedGoogle Scholar
  7. 7.
    Ohtsuka K, Hashimoto M, Suzuki Y (2005) A review of 244 orbital tumors in Japanese patients during a 21-year period: origins and locations. Jpn J Ophthalmol 49(1):49–55. doi: 10.1007/s10384-004-0147-y CrossRefPubMedGoogle Scholar
  8. 8.
    Shields JA, Shields CL, Scartozzi R (2004) Survey of 1264 patients with orbital tumors and simulating lesions: the 2002 Montgomery Lecture, part 1. Ophthalmology 111(5):997–1008. doi: 10.1016/j.ophtha.2003.01.002 CrossRefPubMedGoogle Scholar
  9. 9.
    Khan AM, Varvares MA (2006) Traditional approaches to the orbit. Otolaryngol Clin North Am 39(5):895–909. doi: 10.1016/j.otc.2006.08.008 CrossRefPubMedGoogle Scholar
  10. 10.
    Castelnuovo P, Dallan I, Locatelli D, Battaglia P, Farneti P, Tomazic PV, Seccia V, Karligkiotis A, Pasquini E, Stammberger H (2012) Endoscopic transnasal intraorbital surgery: our experience with 16 cases. Eur Arch Otorhinolaryngol Suppl 269(8):1929–1935. doi: 10.1007/s00405-011-1917-z CrossRefGoogle Scholar
  11. 11.
    Graadt van Roggen JF, Hogendoorn PCW (2004) Solitary fibrous tumour: the emerging clinicopathologic spectrum of an entity and its differential diagnosis. Curr Diagn Pathol 10(3):229–235. doi: 10.1016/j.cdip.2004.01.007 CrossRefGoogle Scholar
  12. 12.
    Stout AP, Cassel C (1943) Hemangiopericytoma of the omentum. Surgery 13(4):578–581Google Scholar
  13. 13.
    Klemperer P, Coleman BR (1931) Primary neoplasms of the pleura. A report of five cases. Am J Indus Med 11:385–412Google Scholar
  14. 14.
    Fletcher CDM, Bridge JA, Lee JC (2013) Extrapleural solitary fibrous tumour. World Health Organization classification of tumours of soft tissue and bone. IARC Press, LyonGoogle Scholar
  15. 15.
    Hanau CA, Miettinen M (1995) Solitary fibrous tumor: histological and immunohistochemical spectrum of benign and malignant variants presenting at different sites. Hum Pathol 26(4):440–449CrossRefPubMedGoogle Scholar
  16. 16.
    Westra WH, Gerald WL, Rosai J (1994) Solitary fibrous tumor: consistent CD34 immunoreactivity and occurrence in the orbit. Am J Surg Pathol 18(10):992–998CrossRefPubMedGoogle Scholar
  17. 17.
    Gengler C, Guillou L (2006) Solitary fibrous tumour and haemangiopericytoma: evolution of a concept. Histopathology 48(1):63–74. doi: 10.1111/j.1365-2559.2005.02290.x CrossRefPubMedGoogle Scholar
  18. 18.
    Fletcher CD (2014) The evolving classification of soft tissue tumours—an update based on the new 2013 WHO classification. Histopathology 64(1):2–11. doi: 10.1111/his.12267 CrossRefPubMedGoogle Scholar
  19. 19.
    Lee JC, Fletcher CD (2011) Malignant fat-forming solitary fibrous tumor (so-called “lipomatous hemangiopericytoma”): clinicopathologic analysis of 14 cases. Am J Surg Pathol 35(8):1177–1185. doi: 10.1097/PAS.0b013e318219cd0b CrossRefPubMedGoogle Scholar
  20. 20.
    Tenekeci G, Sari A, Vayisoglu Y, Serin O (2015) Giant solitary fibrous tumor of orbit. J Craniofac Surg 26(5):390–392. doi: 10.1097/scs.0000000000001868 CrossRefGoogle Scholar
  21. 21.
    DeVito N, Henderson E, Han G, Reed D, Bui MM, Lavey R, Robinson L, Zager JS, Gonzalez RJ, Sondak VK, Letson GD, Conley A (2015) Clinical characteristics and outcomes for solitary fibrous tumor (SFT): a single center experience. PLoS ONE 10(10):e0140362. doi: 10.1371/journal.pone.0140362 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Park MS, Ravi V, Conley A, Patel SR, Trent JC, Lev DC, Lazar AJ, Wang WL, Benjamin RS, Araujo DM (2013) The role of chemotherapy in advanced solitary fibrous tumors: a retrospective analysis. Clin Sarcoma Res 3(1):7. doi: 10.1186/2045-3329-3-7 CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Gao C, Zhang Y, Jing M, Qu W, Li J, Zhao XR, Yu YH (2016) Postoperative radiotherapy for the treatment of solitary fibrous tumor with malignant transformation of the pelvic: a rare case report with literature review. Medicine 95(2):e2433. doi: 10.1097/md.0000000000002433 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Krishnakumar S, Subramanian N, Mohan ER, Mahesh L, Biswas J, Rao NA (2003) Solitary fibrous tumor of the orbit: a clinicopathologic study of six cases with review of the literature. Surv Ophthalmol 48(5):544–554CrossRefPubMedGoogle Scholar
  25. 25.
    Ali MJ, Honavar SG, Naik MN, Vemuganti GK (2013) Orbital solitary fibrous tumor: a rare clinicopathologic correlation and review of literature. J Res Med Sci 18(6):529–531PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive SurgeryNagasaki University School of MedicineNagasakiJapan
  2. 2.Investigative PathologyNagasaki University School of MedicineNagasakiJapan

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