Solitary fibrous tumor of the buccal mucosa: case presentation and review of the literature

Abstract

Introduction

Solitary fibrous tumor (SFT) occurs primarily in adults and is considered an entity of intermediate potential. Most cases follow a benign clinical course, with select tumors exhibiting malignant features. While SFT can occur at any site, the pleural lining of the thorax is the most common. Occurrence in the oral cavity is infrequent. Although histopathology is diverse from case to case, consistent characteristics include a monomorphic spindle cell population in a fibrous stroma with endothelial-lined channels of differing caliber that may show a stag-horn appearance. Treatment is dependent upon the clinical and microscopic features with complete excision and clinical follow-up being appropriate in most cases. We report an SFT of the right buccal mucosa in a female of 29 years and review the literature.

Materials and Methods

A 29-year-old female presented with an oral lesion that had gradually increased in size over 6 months. A nonpainful 1.5 × 1.5 cm spherical mass was identified on the right buccal mucosa.

Results

Incisional biopsy was performed under local anesthesia and the tissue was submitted to pathology. Microscopic features included an intact surface mucosa and underlying moderately-dense proliferation of monomorphic spindle cells possessing inconspicuous cytoplasmic borders arranged haphazardly in a fibrovascular stroma. The spindle cells stained strongly positive for CD-34 and STAT-6 and were negative for S-100 protein, confirming a diagnosis of SFT. The patient underwent excision under general anesthesia. Final histopathology showed tumor-free margins. The patient is free of disease 4-months postoperatively. The overall features of this case (patient age of less than 55 years, tumor size less than five cm, and few mitotic figures), predict a favorable clinical course based on Demiccio and colleagues’ criteria.

Conclusion

The clinical, histopathological, and immunohistochemical features of an SFT in a 29-year-old female are presented and the literature is reviewed. Management and follow-up are discussed.