Korean J Radiol.  2005 Sep;6(3):136-142. 10.3348/kjr.2005.6.3.136.

MR Imaging of Solitary Fibrous Tumors in the Head and Neck

• Kim HJ
• Lee HK
• Seo JJ
• Kim HJ
• Shin JH
• Jeong AK
• Lee JH
• Cho KJ

• KMID: 1102709
• DOI: http://doi.org/10.3348/kjr.2005.6.3.136

Abstract

OBJECTIVE
Solitary fibrous tumor (SFT) is a very rare tumor. The purpose of this study is to determine the MR imaging features of SFT in the intracranial and extracranial head and neck regions. MATERIALS AND METHODS: We retrospectively reviewed six MR images and two CT images of six histologically proven cases of SFT that occurred in four men and two women, and their ages ranged from 46 to 59 years. These imaging findings were correlated with the microscopic findings of their surgical specimens. RESULTS: Six SFTs arose in the meninges (the petrous ridge and the pituitary fossa), the parotid gland, the parapharyngeal space, the buccal space and the maxillary sinus. On the MR images, SFTs in the intracranial and extracranial head and neck regions were mostly isointense to the muscle on the T1-weighted images, they were hyperintense on the T2-weighted images and they all had intense enhancement. On the T1- and T2-weighted images, hypointense lines were observed within in five SFTs. On the CT images, the SFTs were hypodense to the muscle on the unenhanced images and they were heterogeneously enhanced on the contrast-enhanced images. An exceptional case of pituitary SFT was hypointense on the T2-weighted images and it was hyperdense on the unenhanced CT images, which correlated with the increased collagenous component and the cellular compactness. CONCLUSION: The imaging features of SFT are nonspecific; however, SFT should be included in the differential diagnosis of masses involving the intracranial and extracranial head and neck regions.

Keyword

Magnetic resonance (MR) ; Head and neck neoplasms; Head and neck neoplasms, MR

MeSH Terms

Tomography, X-Ray Computed
Soft Tissue Neoplasms/*diagnosis/pathology
Retrospective Studies
Middle Aged
Male
*Magnetic Resonance Imaging
Humans
Head and Neck Neoplasms/*diagnosis/pathology
Female
Adult

Figure

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  Fig. 1 Images of a 56-year-old man presenting with headache (case 1).A. The axial unenhanced CT image shows an ill-defined low density lesion abutting the temporal lobe (*).B. The axial contrast-enhanced CT image demonstrates the lesion to be a well-defined, heterogeneously well-enhanced, rounded and contoured mass.C. The axial T2-weighted MR image (4000/96 [TR/TE]) shows the lesion to be a well-defined, round mass that is heterogeneously hyperintense to the muscle and there are multiple, hypointense streaks (arrows) within the mass.D. The axial T1-weighted MR image (500/11) shows an isointense mass. The hypointense streaks on the T2-weighted image are also hypointense.E. The axial contrast-enhanced T1-weighted MR images (500/11) reveal homogeneous enhancement of the mass that is based on the petrous ridge and it has a dural 'tail' (arrow). The streaks are well enhanced, as same as the other portions of the mass.

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  Fig. 2 Images of a 56-year-old man presenting with visual disturbance (case 2).A. The axial unenhanced CT image shows the lesion to be well-defined and hyperdense.B. The T2-weighted axial MR image (4000/98 [TR/TE]) shows a well-defined 'figure eight' shaped mass that is hypointense to the muscle in the pituitary fossa and it has a suprasellar extension.C. Photomicrograph shows the prominent collagenous tissue with cellular areas that are composed of haphazardly arranged spindle cells. (hematoxylin-eosin stain, original A B magnification (100))

• 

  Fig. 3 Images of a 59-year-old man presenting with a painless left periauricular mass (case 3).A. The T1-weighted axial MR image shows a well-defined, dumbbell-shaped mass (arrows) that is isointense to the muscle in both the left parapharyngeal space and the parotid space with widening of the stylomandibular tunnel. The mass medially displaces the parapharyngeal fat and the carotid sheath. Multiple hypointense streaks are seen in the mass (open arrow).B. The T2-weighted axial MR image shows the heterogeneous high signal intensity of the mass (arrows). The streaks are also demonstrated as low signal intensity (open arrow).C. The contrast-enhanced T1-weighted axial MR image reveals the homogeneously strong enhancement of the mass. The streaks were less enhanced than in the other portion of the tumor.D. Photomicrograph shows that the tumor is composed of a haphazard proliferation of spindle cells separated from the hyalinized collagen tissue (hematoxylin-eosin, magnification × 200). The inlet shows that the tumor cells and the capillary endothelial cells have immunohistochemically positive CD34 results; this finding is consistent with that of solitary fibrous tumor (original magnification × 200).

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