J Rhinol.  2021 Nov;28(3):171-174. 10.18787/jr.2021.00347.

Transnasal Endoscopic Resection of a Huge Solitary Fibrous Tumor Originated From Frontal Recess

• Ryu S
• Lee SY
• Kim SW
• Cho HJ

• KMID: 2522787
• DOI: http://doi.org/10.18787/jr.2021.00347

Abstract

Solitary fibrous tumor (SFT) is a spindle cell neoplasm that occurs commonly in the pleural space. One-third of SFTs arising from an extrathoracic organ are found in the head and neck region, and they arise rarely in the sinonasal tract. Most of these tumors are benign, but malignant tumors are identified in some cases. Here we report a rare sinonasal SFT arising from the frontal recess. A 32-year-old male patient with chief complaint of headache and left facial pain visited the outpatient clinic. He had suffered from paranasal pain and nasal obstruction for several months, and symptoms became more severe in the previous three months. The mass rapidly increased in size and was protruding from the left nostril when he visited the hospital. After computed tomography and magnetic resonance imaging scans, transnasal endoscopic resection of the tumor was performed, and gross total tumor removal was successfully achieved. We believe this case will be helpful for providing information regarding management of such uncommon huge sinonasal tumors originating from the frontal recess.

Keyword

Solitary fibrous tumor; Sinonasal tumor; Endoscoopic resection

Figure

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  Fig. 1. A smooth white mass occupying the entire left nasal cavity found in rigid nasal endoscopy.

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  Fig. 2. A huge heterogeneous enhancing mass with high vascularity in left nasal cavity, maxillary sinus, ethmoid sinus, and both frontal sinuses was found in paranasal sinus CT (A, B) and T1-weighted, T2-weighted and T1-enhanced MRI (C, D, E). The suspicious origin site was frontal recess, and it was labeled by an arrow.

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  Fig. 3. (A) Preoperative and (B) postoperative paranasal CT image finding (coronal plane) of the patient with paranasal SFT. The tumor was successfully excised by transnasal endoscopic approach.

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  Fig. 4. Immunohistochemical stainings of the paranasal sinus tumor were performed to diagnose solitary fibrous tumor. (A) positive for CD34, (B) negative for S100 and (C) SMA (100× magnification).

Reference

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