Orbital solitary fibrous tumor: a clinicopathologic study from a Chinese tertiary hospital with a literature review

Figures & data

Table 1 Summary of the histological features of orbital SFT in the present series

Case No.	CD34	CD99	Bcl-2	SMA	S-100	CK	Desmin	CD117	Ki-67
Case 1	+	+	−	−	−	−	−	−	+ (5%)
Case 2	+	−	+	−	−	−	−	−	+ (<5%)
Case 3	+	−	−	−	−	−	−	−	+ (<5%)
Case 4	+	−	−	−	−	−	−	−	+ (<5%)
2nd operation	+	−	−	−	−	−	−	−	+ (>10%)

Abbreviations: CD, cluster of differentiation; Bcl-2, B-cell lymphoma 2; SMA, smooth muscle actin; CK, cytokeratin; +, positive; −, negative.

Figure 1 Histopathological and immunohistochemical staining of tumors in our cases.

Notes: (A) The tumor is composed of haphazardly arranged spindle cells with bland nuclei and inconspicuous nucleoli. (Case 1; HE staining; original magnification: ×200). (B) Variably collagenous and numerous endothelium-lined vascular channels are noted. (Case 2; arrow shows an occasional vascular channel with a staghorn appearance; HE staining; original magnification: ×200). (C) Tumor cells with oval nuclei, conspicuous nucleoli, and mitotic figure are noted. (recurrent sample of Case 4; HE staining; original magnification: ×200). (D) Tumor cells are positive for CD34. (recurrent sample of Case 4; original magnification: ×200). (E) The tumor cells are positive for Bcl-2 (Case 2; original magnification: ×200). (F) The tumor cells are positive for Ki-67 (>10%), which indicates malignant transformation (recurrent sample of Case 4; original magnification: ×200).

Abbreviations: HE, hematoxylin and eosin; CD34, cluster of differentiation 34; Bcl-2, B-cell lymphoma 2.

Figure 2 MR scan of Case 2 shows a well-circumscribed circular mass in the subcutaneous region of the right lacrimal sac area.

Notes: (A) T1 image, (B) T2 image, and (C) post-contrast T1 image.

Abbreviation: MR, magnetic resonance.

Figure 3 MR scan of Case 3 shows a well-circumscribed subcutaneous mass in the superomedial side of her left orbit with homogeneous isointense signal on T1 images and hypointense signal on T2 images.

Notes: (A) T1 image, (B) T2 image, and (C) post-contrast T1 image.

Figure 4 The MR scan of Case 4 (1st op). Arrows show the lesion had two types of imaging features on MRI. The medial part of the mass indicates a tissue with high collagen content whereas the lateral part indicates a tissue with hypervascular content.

Notes: (A, D) T1 image, (B, E) T2 image, and (C, F) post-contrast T1 image.

Abbreviation: op, operation.

Figure 5 MR scan of Case 4 (2nd operation). Arrows show signal tubular structures, which might represent fast-flow vessels within the tumor.

Notes: (A, D) T1 image, (B, E) T2 image, and (C, F) post-contrast T1 image.

Table 2 Summary of clinical features of orbital SFT in the present series

Case No.	Age (yrs)	Gender	Affected side	Location	Main clinical presentation	Clinical history	Treatment	Time of recurrence (mo)	Follow-up (mo)	Status
1	37	F	R	Lower eyelid	A palpable subcutaneous mass	4 yrs	Total excision	–	27	Alive
2	51	M	R	Lacrimal area	A palpable subcutaneous mass	6 mos	Total excision	–	34	Alive
3	65	F	L	Superomedial orbital quadrant	A palpable subcutaneous mass	1 yr	Total excision	–	26	Alive
4	60	M	L	In the muscle cone	Proptosis, vision disturbance	2 mos	Total excision	14	14	Alive with relapse
2nd operation	60	M	L	Local recurrence	Proptosis, vision disturbance	–	Total excision	–	12	Alive

Abbreviations: F, female; M, male; R, right; L, left; yr, years; mos, months; -, not applicable.

Table 3 Summary of reported recurrent orbital SFT with malignant transformation

Source, year	Age	Gender	Affected side	Initial diagnosis	Initial treatment	Times of recurrence	Final diagnosis	Final treatment
Carrera et al^Citation45	64	M	L	SFT	Total excision	4	Malignant SFT	Re-excision
Manousaridis et al^Citation60	53	F	R	SFT with focal malignant transformation	Total excision	1	Malignant SFT	Re-excision + radiotherapy
Wang et al^Citation61	38	M	R	SFT	Total excision	2	Malignant SFT	Re-excision + radiotherapy
Blandamura et al^Citation62	75	NM	R	SFT	Excision+ radiotherapy	1	SFT with focal malignant transformation	Re-excision
Case 4 in the present study	60	M	L	SFT	Total excision	1	Malignant SFT	Re-excision + radiotherapy

Abbreviations: F, female; M, male; R, right; L, left; NM, not mentioned; SFT, solitary fibrous tumor.

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