A rare case of sinonasal solitary fibrous tumour in a patient with concurrent papillary thyroid carcinoma: A case report

• Published in: Annals of medicine and surgery 2021-12, Vol.72, p.103032, Article 103032
• Main Authors: Mohd Fauzi, Nurul Anis, Ibrahim, Noor Idayu, Wan Abdul Rahman, Wan Faiziah, Tuan Sharif, Sharifah Emilia, Abu Bakar, Muhammad Nasri, Ramli, Ramiza Ramza
• Format: Article
• Language: English
• Subjects: Case Report; Immunohistochemistry; Paranasal sinus neoplasm; Solitary fibrous tumour
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.103032

A solitary fibrous tumour (SFT) is a rare neoplasm that commonly arises in the pleura and can occur in other extrathoracic sites. Extrapleural SFT, particularly in the sinonasal cavity, is extremely rare. There are no definite diagnostic criteria for sinonasal SFT as it is rare. Histologic analysis with immunohistochemistry plays an important role in diagnosing SFT. We report herein a case of SFT of the sinonasal cavity, which later spread to the oral cavity in a 67-year-old male with underlying papillary thyroid carcinoma (PTC) stage IV. He complained of recurrent epistaxis from a mass in his left nasal cavity for two weeks. The mass grew bigger, and spread to the oral cavity, causing dysphagia and upper airway obstruction. Tracheostomy was done under local anaesthesia and a biopsy of the mass was taken to rule out metastasis from the PTC. However, histopathological examination revealed a mesenchymal tumour of fibroblastic type, consistent with an SFT. He was planned for surgical resection of the tumour. However, he refused the operation and was lost to follow-up. We describe the clinical presentation of this rare tumour of the sinonasal and oral cavity, including upper airway obstruction, and the importance of immunohistochemical markers such as CD34 and BCL-2 in diagnosing SFT. Complete resection of the tumour is the definitive treatment for SFT. SFT of the sinonasal and oral cavity is extremely rare. Upper airway obstruction may occur due to the location of the tumour in the airway region. Immunohistochemistry is crucial to distinguish this tumour from other mesenchymal tumours. •Solitary fibrous tumour (SFT) in the nasal cavity and paranasal sinus is extremely rare. In our case, the tumour had spread to the oral cavity, causing upper airway obstruction.•Urgent trachestomy is needed in view of upper airway obstruction due the massive tumour in the upper airway.•Our patient also had double pathology, which was SFT of the sinonasal cavity with underlying papillary thyroid carcinoma (PTC) stage IV. Thus, we had to rule out metastasis from PTC to the sinonasal cavity.•Immunohistochemical studies are the most sensitive and specific method for diagnosing an SFT. Among the most sensitive first-line markers are CD34, BCL-2 and STAT6.