Abstract
Solitary fibrous tumors (SFTs) uncommonly involve the head and neck region. Head and neck SFTs (HNSFTs) exhibit diverse histological features and can mimic several neoplasms with different treatment and behavior. Herein, we report the clinicopathological features of three cases of HNSFT. Case 1 was a 29-year-old female who presented with a nasal cavity mass measuring 3.5 cm. The patient underwent surgical excision. Microscopic examination revealed classic histological and immunohistochemical (IHC) features of SFT. Unusual histological features included epithelioid morphology, clear cells, and edematous change. She developed local recurrence after 11 months, which was also treated with surgery. Case 2 was a 55-year-old male who developed a 1-cm mass at the buccal mucosa. Surgical excision of the tumor was performed. The tumor was completely circumscribed microscopically. Characteristic histological and IHC features of SFT were identified. Unusual histological features observed were an adenomatous pattern, clear cells, and myxoid change. The patient was alive and disease-free at the 12-month follow-up. Case 3 was a 59-year-old female presenting with a medial canthus mass measuring 1.4 cm. The patient underwent surgical excision. Histological and IHC features observed were diagnostic for SFT. Unusual histological features identified were wavy nuclei and multinucleated stromal giant cells. The patient was alive and disease-free at the 124-month follow-up. Diagnosis of SFT can be challenging in unusual locations like the head and neck region. In addition, the histological spectrum of HNSFT is diverse. Therefore, knowledge about unusual histological features and classic IHC expression is essential for establishing correct diagnosis. Long-term follow-up is recommended because of the risk of recurrence in HNSFT.